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Eye Exam, New Patient, Comprehensive

South Dakota 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?

$141

Typical negotiated rate. In South Dakota, July 2026.

Insurers have agreed to pay about $141 for this service. The price depends on where it is billed: about $141 from a physician practice, and about $129 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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 8 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$141$93.33 to $170
FacilityA hospital or hospital-owned outpatient department$129$79.43 to $135

How much rates vary

Facilitymedian $129 · 10th to 90th $42 to $178Professionalmedian $141 · 10th to 90th $72 to $229
$10$20$50$100$200facility $129professional $141

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. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$128.82
Typical High
$134.90
Aetna
Setting
Facility
Modifier
25 · Same-day visit
Typical Low
$87.10
Median
$87.10
Typical High
$87.10
Aetna
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$141.25
Typical High
$229.09
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$91.20
Median
$323.59
Typical High
$331.13
Avera
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$213.80
Typical High
$239.88
Cigna
Setting
Professional
Modifier
Global
Typical Low
$81.28
Median
$194.98
Typical High
$331.13
Medica
Setting
Facility
Modifier
Global
Typical Low
$79.43
Median
$141.25
Typical High
$257.04
Medica
Setting
Professional
Modifier
Global
Typical Low
$120.23
Median
$190.55
Typical High
$389.05
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$223.87
Median
$275.42
Typical High
$302.00
Midlands
Setting
Professional
Modifier
Global
Typical Low
$194.98
Median
$295.12
Typical High
$363.08
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$131.83
Median
$181.97
Typical High
$288.40
United
Setting
Facility
Modifier
Global
Typical Low
$58.88
Median
$72.44
Typical High
$112.20
United
Setting
Professional
Modifier
Global
Typical Low
$64.57
Median
$128.82
Typical High
$251.19
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$138.04
Median
$169.82
Typical High
$323.59

Where South Dakota 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.

South Dakota· 12th of 51

$141

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.