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

Molina pricing summary

Low

$30

Average

$67

Median

$60

High

$145

Molina rate distribution

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46 hospital rates

#		Plans
1	AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient	1	$60	$60	—	—	—	$60 – $60
2	BELLEVUE MEDICAL CENTER LLC Bellevue, NE fee schedule · outpatient	1	$81	$81	—	—	—	$81 – $81
3	BELLEVUE MEDICAL CENTER LLC Bellevue, NE percent of total billed charges · outpatientfrom % of charges	1	$35	$35	—	—	—	$35 – $35
4	CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient	1	$59	$59	—	—	—	$59 – $59
5	CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient	1	$106	$106	—	—	—	$106 – $106
6	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Mentor, OH facility · case rate · outpatient	1	$65	$65	—	—	—	$65 – $65
7	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Euclid, OH facility · case rate · outpatient	1	$66	$66	—	—	—	$66 – $66
8	CLEVELAND CLINIC HEALTH SYSTEM - EAST REGION Warrensville Heights, OH facility · case rate · outpatient	1	$69	$69	—	—	—	$69 – $69
9	Cleveland Clinic Mercy Hospital Canton, OH facility · case rate · outpatient	1	$59	$59	—	—	—	$59 – $59
10	Fairview Hospital Cleveland, OH facility · case rate · outpatient	1	$62	$62	—	—	—	$62 – $62
11	Fisher-Titus Medical Center Norwalk, OH facility · case rate · outpatient	1	$44	$44	—	—	—	$44 – $44
12	Gottlieb Memorial Hospital Melrose Park, IL facility · case rate · outpatient	1	$80	$80	—	—	—	$80 – $80
13	Henry Ford Health System West Bloomfield, MI professional · fee schedule · outpatient	4	$60	$60	$0	1%	—	$60 – $61
14	Henry Ford Health System Plymouth, MI professional · fee schedule · outpatient	4	$60	$60	$0	1%	—	$60 – $61
15	Henry Ford Macomb Hospital Corporation Clinton Twp, MI professional · fee schedule · outpatient	4	$60	$60	$0	1%	—	$60 – $61
16	Henry Ford Wyandotte Hospital Brownstown Charter Twp., MI professional · fee schedule · outpatient	4	$60	$60	$0	1%	—	$60 – $61
17	Kalkaska Memorial Health Center Kalkaska, MI professional · fee schedule · both	1	$56	$56	—	—	—	$56 – $56
18	LODI COMMUNITY HOSPITAL Lodi, OH facility · case rate · outpatient	1	$101	$101	—	—	—	$101 – $101
19	LUTHERAN HOSPITAL Cleveland, OH facility · case rate · outpatient	1	$59	$59	—	—	—	$59 – $59
20	Loyola University Medical Center Maywood, IL facility · case rate · outpatient	1	$80	$80	—	—	—	$80 – $80
21	MARYMOUNT HOSPITAL INC Garfield Heights, OH facility · case rate · outpatient	1	$59	$59	—	—	—	$59 – $59
22	MEDINA HOSPITAL Medina, OH facility · case rate · outpatient	1	$61	$61	—	—	—	$61 – $61
23	MacNeal Hospital Berwyn, IL facility · case rate · outpatient	1	$80	$80	—	—	—	$80 – $80
24	Munson Healthcare Cadillac Cadillac, MI professional · fee schedule · both	1	$56	$56	—	—	—	$56 – $56
25	Munson Healthcare Grayling Grayling, MI professional · fee schedule · both	1	$56	$56	—	—	—	$56 – $56