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Eye Exam, Established Patient, Intermediate

Montana 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?

$97.72

Typical physician fee. In Montana, July 2026.

Insurers have agreed to pay about $97.72 for this service. Most negotiated rates run $72.44 to $135.

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 6 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $91 · 10th to 90th $59 to $155Professionalmedian $100 · 10th to 90th $55 to $170
$50$100$200facility $91professional $100

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
$54.95
Median
$100.00
Typical High
$186.21
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$89.13
Median
$91.20
Typical High
$91.20
BCBS
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$77.62
Typical High
$141.25
Cigna
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$79.43
Typical High
$141.25
MountainHealth Co-op
Setting
Facility
Modifier
Global
Typical Low
$85.11
Median
$107.15
Typical High
$154.88
MountainHealth Co-op
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$107.15
Typical High
$154.88
Providence
Setting
Facility
Modifier
Global
Typical Low
$40.74
Median
$72.44
Typical High
$125.89
Providence
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$79.43
Typical High
$141.25
United
Setting
Professional
Modifier
Global
Typical Low
$47.86
Median
$97.72
Typical High
$169.82
United
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$104.71
Median
$104.71
Typical High
$104.71

Where Montana 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.

Montana· 1st of 51

$97.72

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.