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Eye Exam, Established Patient, Intermediate

Idaho 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?

$87.10

Typical physician fee. In Idaho, July 2026.

Insurers have agreed to pay about $87.10 for this service. Most negotiated rates run $67.61 to $110.

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 $78 · 10th to 90th $42 to $138Professionalmedian $87 · 10th to 90th $48 to $155
$20$50$100$200$500facility $78professional $87

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
$47.86
Median
$87.10
Typical High
$154.88
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$72.44
Median
$93.33
Typical High
$151.36
BCBS
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$104.71
Typical High
$173.78
Cigna
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$77.62
Typical High
$141.25
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$41.69
Median
$77.62
Typical High
$138.04
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$46.77
Median
$91.20
Typical High
$181.97
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$67.61
Typical High
$123.03
Select Health
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$85.11
Typical High
$91.20
United
Setting
Professional
Modifier
Global
Typical Low
$42.66
Median
$74.13
Typical High
$125.89

Where Idaho 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.

Idaho· 7th of 51

$87.10

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.