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Eye Exam, Established Patient, Intermediate

Oregon 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?

$89.13

Typical negotiated rate. In Oregon, July 2026.

Insurers have agreed to pay about $89.13 for this service. The price depends on where it is billed: about $87.10 from a physician practice, and about $138 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

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.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$87.10$67.61 to $123
FacilityA hospital or hospital-owned outpatient department$138$87.10 to $166

How much rates vary

Facilitymedian $138 · 10th to 90th $54 to $174Professionalmedian $87 · 10th to 90th $48 to $186
$50$100$200facility $138professional $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
$46.77
Median
$85.11
Typical High
$147.91
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$89.13
Median
$93.33
Typical High
$245.47
Cigna
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$104.71
Typical High
$199.53
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$117.49
Typical High
$218.78
Moda Health
Setting
Facility
Modifier
Global
Typical Low
$43.65
Median
$83.18
Typical High
$158.49
Moda Health
Setting
Professional
Modifier
Global
Typical Low
$69.18
Median
$112.20
Typical High
$194.98
Pacific Source
Setting
Facility
Modifier
Global
Typical Low
$100.00
Median
$165.96
Typical High
$177.83
Providence
Setting
Facility
Modifier
Global
Typical Low
$43.65
Median
$83.18
Typical High
$165.96
Providence
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$112.20
Typical High
$194.98
Regence BlueShield
Setting
Professional
Modifier
Global
Typical Low
$51.29
Median
$117.49
Typical High
$223.87
United
Setting
Professional
Modifier
Global
Typical Low
$53.70
Median
$97.72
Typical High
$165.96

Where Oregon 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.

Oregon· 4th of 51

$89.13

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.