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Eye Exam, Established Patient, Intermediate

South Carolina 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 South Carolina, July 2026.

Insurers have agreed to pay about $72.44 for this service. Most negotiated rates run $47.86 to $89.13.

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 7 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $78 · 10th to 90th $45 to $123Professionalmedian $72 · 10th to 90th $40 to $123
$50$100$200facility $78professional $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. 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
$74.13
Typical High
$125.89
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$47.86
Median
$89.13
Typical High
$316.23
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$79.43
Median
$85.11
Typical High
$158.49
Ambetter
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$85.11
Median
$87.10
Typical High
$95.50
BCBS
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$61.66
Typical High
$107.15
Cigna
Setting
Professional
Modifier
Global
Typical Low
$40.74
Median
$69.18
Typical High
$141.25
Medcost
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$77.62
Typical High
$123.03
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$33.11
Typical High
$33.11
United
Setting
Professional
Modifier
Global
Typical Low
$34.67
Median
$53.70
Typical High
$87.10

Where South Carolina 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.

South Carolina· 35th 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.