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Eye Exam, Established Patient, Intermediate

Washington, DC rates for HCPCS 92012

This is a medical eye examination for a patient who has previously been seen by the practice, covering a moderate level of evaluation and continuing or adjusting an existing treatment plan. It's typically used for routine follow-up of an existing eye condition rather than a new or highly complex problem.

Rates data updated July 2026.

How much does Eye Exam, Established Patient, Intermediate cost?

$60.26

Typical physician fee. In Washington, DC, July 2026.

Insurers have agreed to pay about $60.26 for this service. Most negotiated rates run $39.81 to $75.86.

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 5 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $60 · 10th to 90th $39 to $91
$20$50$100professional $60

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
Professional
Modifier
Global
Typical Low
$38.90
Median
$52.48
Typical High
$89.13
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$100.00
Median
$100.00
Typical High
$100.00
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$33.88
Median
$47.86
Typical High
$63.10
Cigna
Setting
Professional
Modifier
Global
Typical Low
$38.90
Median
$66.07
Typical High
$128.82
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$97.72
Median
$112.20
Typical High
$208.93
United
Setting
Professional
Modifier
Global
Typical Low
$36.31
Median
$72.44
Typical High
$199.53

Where Washington, DC sits

The same service costs 1.9 times more in Montana 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.

Washington, DC· 50th of 51

$60.26

MT $97.72DE $51.29

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.