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Eye Exam, Established Patient, Intermediate

Georgia 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?

$75.86

Typical physician fee. In Georgia, July 2026.

Insurers have agreed to pay about $75.86 for this service. Most negotiated rates run $51.29 to $91.20.

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.

How much rates vary

Facilitymedian $46 · 10th to 90th $46 to $46Professionalmedian $76 · 10th to 90th $42 to $145
$20$50$100$200facility $46professional $76

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
$41.69
Median
$79.43
Typical High
$144.54
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$83.18
Median
$147.91
Typical High
$223.87
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$89.13
Median
$120.23
Typical High
$131.83
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$85.11
Median
$102.33
Typical High
$162.18
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$67.61
Typical High
$125.89
CareSource
Setting
Facility
Modifier
Global
Typical Low
$45.71
Median
$45.71
Typical High
$45.71
CareSource
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$109.65
Typical High
$109.65
Cigna
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$79.43
Typical High
$173.78
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$52.48
Median
$109.65
Typical High
$234.42
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$67.61
Median
$114.82
Typical High
$134.90
United
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$67.61
Typical High
$107.15

Where Georgia 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.

Georgia· 24th of 51

$75.86

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.