Routine eye examination

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HB EST ROUTINE OPHTHALMOLOGICAL EXAM

Payers reporting HCPCS S0621

Payer pricing summary

Low

Average

$103

Median

$82

High

$341

Payer rate distribution

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#
1	Blue Cross Blue Shield fee schedule · outpatient · +12 other terms	93	$140	$143	$94	66%	—	$0 – $539
2	Bcbs Tx fee schedule · outpatient · +1 other terms	26	$139	$129	$47	37%	—	$44 – $235
3	Aetna fee schedule · outpatient · +13 other terms	22	$41	$89	$83	93%	—	$38 – $380
4	Cigna facility · fee schedule · outpatient · +8 other terms	18	$42	$60	$41	69%	—	$29 – $215
5	Molina facility · case rate · outpatient · +10 other terms	18	$66	$70	$15	22%	—	$44 – $106
6	Anthem facility · case rate · outpatient · +7 other terms	15	$62	$68	$16	23%	—	$42 – $106
7	Caresource facility · case rate · outpatient · +1 other terms	15	$63	$68	$16	23%	—	$42 – $108
8	UnitedHealthcare facility · case rate · outpatient · +11 other terms	15	$63	$69	$16	23%	—	$44 – $108
9	Wellmark fee schedule · both · +3 other terms	13	$140	$138	$15	11%	—	$76 – $156
10	Amerihealth Caritas fee schedule · both · +1 other terms	12	$60	$60	—	—	—	$60 – $60
11	Bcbs Mn fee schedule · outpatient · +3 other terms	12	$147	$112	$62	55%	—	$49 – $185
12	WellCare fee schedule · both · +4 other terms	12	$60	$60	$0	0%	—	$59 – $60
13	Optum facility · case rate · outpatient · +1 other terms	11	$59	$64	$14	22%	—	$53 – $96
14	Highmark fee schedule · outpatient · +2 other terms	10	$44	$44	—	—	—	$44 – $44
15	Aetna Better Health fee schedule · inpatient · +4 other terms	7	$39	$39	—	—	—	$39 – $39
16	Humana facility · other · outpatient · +8 other terms	6	$71	$78	$13	16%	—	$71 – $106
17	MultiPlan percent of total billed charges · outpatientfrom % of charges · +6 other terms	5	$186	$266	$147	55%	—	$0 – $385
18	Oscar percent of total billed charges · bothfrom % of charges · +4 other terms	5	$58	$59	$4	6%	—	$58 – $70
19	Ambetter fee schedule · both	4	$0	$0	—	—	—	$0 – $0
20	Phcs percent of total billed charges · bothfrom % of charges · +1 other terms	4	$85	$85	—	—	—	$85 – $85
21	Tricare facility · other · outpatient · +1 other terms	4	$71	$71	—	—	—	$71 – $71
22	First Health professional · fee schedule · both · +2 other terms	3	$44	$44	—	—	—	$44 – $44
23	Medica fee schedule · outpatient · +1 other terms	3	$77	$94	$40	43%	—	$74 – $192
24	Medicaid fee schedule · outpatient	3	$1	$65	$90	139%	—	$1 – $192
25	Healthpartners professional · fee schedule · both · +4 other terms	2	$113	$113	$27	24%	—	$86 – $140

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