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Eye Exam, Established Patient, Intermediate

Michigan 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?

$72.44

Typical physician fee. In Michigan, July 2026.

Insurers have agreed to pay about $72.44 for this service. Most negotiated rates run $50.12 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 $60 · 10th to 90th $47 to $60Professionalmedian $72 · 10th to 90th $43 to $115
$50$100facility $60professional $72

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
$42.66
Median
$72.44
Typical High
$117.49
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$79.43
Median
$95.50
Typical High
$117.49
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$63.10
Median
$85.11
Typical High
$85.11
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$56.23
Median
$85.11
Typical High
$89.13
BCBS
Setting
Professional
Modifier
Global
Typical Low
$45.71
Median
$53.70
Typical High
$107.15
CareSource
Setting
Facility
Modifier
Global
Typical Low
$46.77
Median
$60.26
Typical High
$60.26
CareSource
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$81.28
Typical High
$81.28
Cigna
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$67.61
Typical High
$199.53
Health Alliance Plan
Setting
Professional
Modifier
Global
Typical Low
$39.81
Median
$72.44
Typical High
$114.82
Priority Health
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$147.91
Typical High
$363.08
United
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$67.61
Typical High
$107.15

Where Michigan 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.

Michigan· 37th of 51

$72.44

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.