Fees listed by CPT Procedure Code

Here at LOOK, we feel that pricing transparency is critical for providing excellent customer service. This lists most of our commonly filed CPT procedure codes and the associated pricing.

Most Common Billing Codes that are Not Covered by Insurance
S0620 Routine eye exam including refraction new patient Self pay $120
S0621 Routine eye exam including refraction established Patient Self pay $120
92310 Contact Fit -New Normal $100
92310 Contact Fit - Established Normal $75
92314 OCT/Fundus Photo screening $39 

Most Common Billing Codes Covered by Vision Insurance
92004 Comprehensive Examination - new patient $175
92014 Comprehensive Examination - Established Patient $145
92015 Determination of Refractive State $25

Most Common Billing Codes Covered by Medical Insurance
99203 Examination Level III - New Patient $125
99213 Examination Level III - Established $103
99204 Examination Level IV - New Patient $187
99214 Examination Level IV - Established $145
92133 Optical Coherence Tomography of Optic Nerve (OCT) unilateral/bilateral $50
92134 Optical Coherence Tomography of Retina (OCT) unilateral/bilateral $50
92250 Fundus Photography $50
92083 Visual Field Extended examination $85
68761 Closure of Lacrimal Punctum by Plug $160