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Eye Exam, Established Patient, Intermediate

South Dakota 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 South Dakota, July 2026.

Insurers have agreed to pay about $87.10 for this service. Most negotiated rates run $69.18 to $105.

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 $76 · 10th to 90th $38 to $155Professionalmedian $87 · 10th to 90th $47 to $158
$10$20$50$100$200facility $76professional $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
$125.89
Aetna
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$89.13
Median
$89.13
Typical High
$194.98
Avera
Setting
Professional
Modifier
Global
Typical Low
$77.62
Median
$138.04
Typical High
$144.54
Cigna
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$104.71
Typical High
$199.53
Medica
Setting
Facility
Modifier
Global
Typical Low
$42.66
Median
$85.11
Typical High
$154.88
Medica
Setting
Professional
Modifier
Global
Typical Low
$75.86
Median
$131.83
Typical High
$331.13
Medica
Setting
Professional
Modifier
25 · Same-day visit
Typical Low
$131.83
Median
$147.91
Typical High
$147.91
Midlands
Setting
Professional
Modifier
Global
Typical Low
$102.33
Median
$169.82
Typical High
$213.80
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$70.79
Median
$104.71
Typical High
$169.82
United
Setting
Facility
Modifier
Global
Typical Low
$30.90
Median
$37.15
Typical High
$67.61
United
Setting
Professional
Modifier
Global
Typical Low
$41.69
Median
$74.13
Typical High
$138.04
Wellmark
Setting
Professional
Modifier
Global
Typical Low
$74.13
Median
$89.13
Typical High
$194.98

Where South Dakota 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 Dakota· 5th 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.