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Eye Exam, New Patient, Comprehensive

New Jersey rates for HCPCS 92004

This is a thorough initial eye examination for a patient new to the practice, including a detailed history, a full exam of the eye's structures and vision, and the start of a treatment or monitoring plan. It's more extensive than a basic vision check and is often used to evaluate new or complex eye concerns.

Rates data updated July 2026.

How much does Eye Exam, New Patient, Comprehensive cost?

$112

Typical physician fee. In New Jersey, July 2026.

Insurers have agreed to pay about $112 for this service. Most negotiated rates run $87.10 to $148.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $263 · 10th to 90th $251 to $282Professionalmedian $112 · 10th to 90th $68 to $178
$50$100$200facility $263professional $112

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$112.20
Typical High
$169.82
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$114.82
Median
$151.36
Typical High
$281.84
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$165.96
Typical High
$165.96
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$128.82
Median
$251.19
Typical High
$831.76
Cigna
Setting
Professional
Modifier
Global
Typical Low
$66.07
Median
$128.82
Typical High
$288.40
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$70.79
Typical High
$186.21
Horizon BCBS
Setting
Facility
Modifier
Global
Typical Low
$251.19
Median
$263.03
Typical High
$281.84
Horizon BCBS
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$186.21
Typical High
$407.38
United
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$83.18
Typical High
$169.82

Where New Jersey sits

The same service costs 1.6 times more in California than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

New Jersey· 47th of 51

$112

CA $158DE $97.72

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.