One question we get a lot from prospective patients is what will an exam at our office cost. The answer is, of course, it depends. We want to review some of the most common costs to help demystify the confusion between vision plans, medical insurance and some services that aren’t eligible for either.
Click here to review the value of an exam with us verses some of our competitors. It lists some of the things we educate our patients about every day. We customize your experience to your needs. When you join us as a patient, you’re gaining more than just a once a year visit. By choosing us, you’re purchasing peace of mind that our doctors have your back for all your eye care and vision needs.
Our many after appointment perks including:
- 24/7 urgent care access to OUR doctors not some random person across town who doesn’t have access to your records
- Glasses, contact lens or eye disease experts are a call away for questions (and yes, our staff or doctor actually calls you back)
- Expert referrals to specialists based on your needs and preferences rather than leave you to figure it out, we setup the appointment for you as well as send and receive correspondence about your care
- Issues with your glasses or contacts? No problem. We want you to see well and want to fix your issue
- We’ll never force you to purchase anything or buy contacts without trying them out first.
Which best describes you?
Wellness Eye Exam Cost
If you have a vision plan like VSP (vision service plan) or EyeMed (the only vision plans we accept), you will have a co-pay around $10-20, but can be as much as $50 or as little as $0. This covers both a screening of your eye health as well as the refraction (the part of your visit that figures out your glasses prescription).
If you are paying cash for your wellness exam, it will cost $80 for a new patient’s eye health evaluation ($70 if we’ve seen you before) and $48 for the refraction.
Retinal screen photos, which allow your doctor to closely monitor your eye health for changes, are rarely covered and cost $39; our doctors recommend repeating these about every 3-5 years for those without retinal issues. Our doctors can’t adequately do their job without theses photos. Currently, our doctors strongly recommend screening photos on your first or second visit.
Contact Lens Services
Contact lens services aren’t covered by vision plans or medical insurance, but some do offer discounts. They are usually around 15% off. These fees are in addition to an office visit or wellness exam.
Annual contact lens evaluation is included in all of our contact lens services and includes the following: Your doctor evaluates your eye health in detail (especially lids & cornea), determines the curvature of your eye and maps the front surface. Next, they use this information along with your refraction results to establish an initial lens to fit you into.
New Contact Lens Wearer?
If you’re new to contacts, after the evaluation with your doctor, you’ll be spending time with our contact lens technician learning insertion and removal techniques. This can be scheduled at the same time as your appointment or another day. After you get the hang of handling your new lenses, you’ll be given diagnostic lenses to use for a few days at home. Next, you return to see your doctor again to see how well the lenses are working. We won’t finalize your prescription until your doctor confirms the lenses work. Most new wearers have about 2 follow ups after the insertion and removal training. This doesn’t occur often, but more visits may be needed if the initial lens didn’t work well.
All of our contact lens fees, for new wearers and those changing lenses, cover any needed follow ups.
Current Contact Lens Wearer?
Doing well with the contact you’re already wearing? Great! Then it’s less work for our doctors and less follow up visits for you. This translates into a lower fee for you. Typically, this will involve only the annual ocular evaluation and confirmation of the lens parameters are working well. This can be combined with your wellness exam. Usually, there is no extra charge for tweaking a prescription if the lens remains otherwise the same. (i.e. no follow up needed)
Price range for annual contact lens evaluation:
If you are already familiar with wearing contacts but need a change to the brand, lens shape or type of material, follow ups are usually needed. This will cost less than a new wearer, as you don’t need insertion and removal training, but more than if everything remains the same. We bundle our fees so their is one global fee for all needed follow up and any diagnostic contacts. The amount of follows up you may need can vary, but is usually between 1 and 2 after your exam. However, sometimes a lens your doctor thought would work didn’t, and another option is needed.
Bottom Line on Our Contact Lens Fees:
The more challenging your eye is to fit, the most time our doctors need to figure out a solution for you, increasing the fee. This is why our staff can’t give exact quotes. Until we know your contact lens prescription and state of your eye health (to determine your current lenses aren’t causing you issues), we are unable to give an exact price.
Click here to schedule an appointment online, or call us at (816) 524-8900 or text us at 94369.
Medical Eye Evaluation Costs
If you have medical insurance, it’s hard to determine the exact cost as some people owe copays and others with high deductibles will owe more. Generally, we find that those with high deductible pay about the same as our cash discount pricing for office visits, (aka the eye health evaluation, explanation of what’s going on and what’s going to be done about it). Because there is so much less work when we collect the fee the day we see you, we offer a 25% discount of these services. (We greatly appreciate avoiding insurance claims, so we pass the saving on to you. Discount is taken into account in all prices shown.)
Since medical insurance helps cover some of your eye exam’s costs, those with HMO or PPOs can expect to pay less than the cash pricing below. If our office is not “in-network” with your insurance plan, it may be most cost effective to use cash pricing than the higher fees for “out-of-network” coverage. Our staff will work with you to figure this out, but it can take some time if we don’t have your insurance details before the visit.
Pro Tip: Get your insurance and vision plan information to us BEFORE your visit. Then, we do the rest. We’ll verify your insurance beforehand so there is no confusion about what you owe when you’re here for your appointment. Text a picture of your card to our office number: 94369.
Price Ranges for Detailed Eye Health Evaluations (aka Medical Office Visits):
For a New Patient w/o insurance: ~$80 to 200
For a Returning Patient w/o insurance: ~$60 to 150
You’ll notice that fees have a broad range owing to the complexity of the visit. The more complex your issues (more work for your doctor) or the more time they spend with you, the most expensive it is. Visits focusing on new issues typically cost more than than follow ups for the same condition.
Medical Eye Exam Cost Example:
New patient who is diabetic who needs a detailed ocular health and dilated retinal evaluation (~$155) with medical retinal photos ($124*) and refraction ($48).
The same patient is returning in 6 months to evaluate retinal changes (~$125 for office visit) likely won’t need imaging or refraction again.
Coordination of Benefits:
Most medical insurance plans don’t cover refractions. If you have a Vision Service Plan (VSP), they sometimes allow us to coordinate their coverage with your medical plan. They let our office bill the refraction, which isn’t covered, to them (VSP) rather make you pay for it.
A few EyeMed plans let us do this, but most don’t. If you have a vision plan that doesn’t coordinate, we recommend 2 visits; first visit to check eye health, billing your medical plan, and a second visit to check your refraction, billing EyeMed.
If this is confusing, we agree with you. We feel if you have a vision plan, they should pay the part your premiums cover, regardless of if you have a medical condition. Sadly, this is not something we can change; only members (those who pay the premiums) can influence change within a vision plan.
Click here to schedule an appointment online, or call us at (816) 524-8900 or text 94369.
Urgent Care Costs
Most patients coming to us for urgent care needs don’t need as detailed of a visit as those with chronic issues explained above. Rather, they usually need a foreign body removed or need medication for allergies that got out of hand or an infection. Our doctors preform A LOT of urgent care and have seen it all from patients with retinal detachments to ocular STD infections, Herpes Zoster (chicken pox virus) to cancerous growths to babies scratching their parents’ eye.
Why we provide 24/7 Urgent Care to our patients
We know how painful it can be and we work hard to get you seen quickly and off to a specialist if needed. Unlike an urgent care facility, we can examine you in detail with a microscope and usually for a similar cost. Our local hospitals do a great job, but they can be costly and take a long time before you’re seen.
We have 1 of our doctors available anytime; if we’re closed, call our office number and leave a brief message. They will call you back; sometimes your issue can be solved over the phone or can wait for a day or 2. More often we meet you at our office and figure out what’s going on.
During regular business hours, we work you in to our schedule to the best of our ability. Sometimes, we ask you to come in and the next available doctor will see you. That’s one advantage of having a few doctors in the clinic at a time: less wait time for you.
Cost range for Urgent Care Office Visit (New Patients): ~$85 to 155, with most landing around $100.
Cost range for foreign body removal: ~$105, this is usually charged instead of an office visit.
Estimate of eye medication costs:
Most generic antibiotic eye drops are usually less than $50 (tobramycin/polytrim/ciprofloxacin ~$15).
Antivirals can be more but are usually an pill rather than drops (Valcyclovir ~$30).
Antihistamines like Pataday are usually less than $25 and are over the counter.
Steroids (like prednisolone) and other anti-inflammatories (ketorolac) are typically $35 or less.
Antibiotic + steroid drops are likely around $60. Check GoodRx for most current pricing.
Commonly Performed Eye Tests: What they are and Why we do them
Refraction: $48 Most common eye test; it figures out your glasses prescription; changes here tell your doctor if diabetic blood sugar is too high, if cataracts have gotten worse, if macular degeneration is progressing, or if your eye is growing (in kids). Rarely covered by medical insurance.
*Medical retinal photos: $124 This common retinal image involves the doctor reviewing it (usually with you), then describing details about the photo in your medical record; it gives the doctor a better idea of what’s happening in your eye and allows them to track changes closely. Diabetic eye disease, glaucoma, retinal tears and macular changes as well as blood vessel changes from hypertension or high cholesterol are observed with these images just to name a few. These can be repeated every few years or much more frequently depending on your eye health.
Retinal screening photos: $39 This is a baseline image our doctors use to monitor your retinal health for subtle changes over time. It’s one of the most powerful tools we have to keep tabs on your eye health. We discount this from the medical photo as the is no report created and less patient education is needed. Also, we strongly feel everyone over 25 should have one, so we want the fee to be in reach for all our patients.
Other Less Common Eye Tests
Retinal (Macular) or Optic Nerve OCT (Optical coherence tomography): $84 This one is hard to explain without pictures, please see this page for more details. It allows your doctor to monitor important or fragile tissue for changes within a few microns. Uses include monitoring epiretinal membranes, macular degeneration, retinal cysts or swelling as well as optic nerve thinning or swelling.
Visual field: $84-124 This test maps out how well you can see in different parts of your eye. Commonly, areas of 24 to 30 degrees from the central, detailed spot are mapped out; this is used for patients with optic nerve issues like glaucoma or increase intracranial pressure, (CSF pushes on the back of the eye). The test lasts about 5 minutes per eye. This test is also used to determine if your eyelids are droopy enough to have insurance cover a lid lift procedure.
Corneal topography: Included in contact lens evaluation; maps out the curvature of your cornea. This helps your doctor figure out which lens to fit you with. They also use this to monitor those who had refractive surgery in the past.
Pachymetry and corneal OCT: $74 This measures the corneal thickness; your doctor uses this test for patients with corneal transplants or keratoconus to monitor the integrity of the tissue.
It’s Your Money: Refunds
Our business handles refunds and overpayments a little differently than most medical offices: we don’t like to keep your money in our bank account! Not only do we refund large values (sometimes we just can’t get glasses right), we also refund any balance over $1.
Why do I have a balance?
Overpayments generally occur when patients have more than one medical insurance company or we coordinate benefits with a vision plan. Example: Medicare covers only 80% of fees, and many patients have a supplemental plan to help pay the other 20%.
Our staff does a great job figuring out what you owe for a single insurance or vision plan, but things get complicated when 2 plans mix together. The first payer is easy, as it follows the rules we expect; we collect the copay from your insurance card, or the price your insurance negotiated is applied to your deductible. The trouble comes when the second plan is applied to what the first one didn’t pay. Since every plan has it’s own rules on what a secondary insurance should pay, it’s nearly impossible to collect the exact correct amount at the end of your visit. Sometimes we don’t collect enough and we send you a small bill, other times we collect slightly too much. This generates a balance on your account.
How our refunds work:
Our staff works on this once a month, processing refunds or overpayments after filing all insurances paperwork and receiving all payments. Sometimes, like when there is a high deductible, we may send you a bill for the remaining balance. But, just as often, your insurances paid more than we expected, and you receive some of your copayment back. Frequently, we send our patients checks for small values like $12 or even $2! These go out to 100s patients annually.
That balance on our books is your money and you’ll get it back.
- Our staff figures out if there is a balance, without hassle, for you
- You’ll receive a refund check without asking for it
- And no, you don’t have to call us. No trying to to figure out if we’ll refund you, or where the check is.
- Minors with a balance won’t receive a check, rather we send it to the person responsible for their account
Bottom Line with Pricing:
If you still have questions about how much something might cost at our office, please contact us and give us an opportunity to earn your business. We treat our patients how we want to be treated when we seek care elsewhere, and offering refunds without hassle, explaining costs up front and clear explanation of our services is just a few of the many ways we do this. Your doctor will even try to help you find new providers when you move!
We look forward to earning your confidence for all your eye care needs for years to come. Here are more reasons to choose us.
Our skilled team can help you see more clearly for life! Please call or text us at 816-524-8900 or schedule your eye exam online today.
Last updated January 2022 by Laura Nennig, OD, doctor and owner; she specializes in contact lens fittings, with advanced training with scleral lenses and has a passion for ocular wellness.
