Insurance Information
Shawnee Vision Source works with many insurance carriers. Here’s a list of some of the featured carriers we accept.
To see if we work with your insurance carrier, please call our office for assistance. Our friendly and informed staff will be happy to answer any questions you may have.
Keep these things in mind:
- Insurance coverage doesn’t mean payment. Many health plans have copayments and deductibles that must be met before your insurance will pay any amount towards your bill.
- Although we do everything we can to assist our patients in determining their insurance benefits, it is the responsibility of the patient to know what medical and routine vision coverage plan or plans they have prior to the time of the exam or material order. Please check with your insurance carrier prior to your office visit to make sure you have routine vision benefits (and what they are), who your routine vision administrator is and to confirm that our doctors are classified as providers in your plan, and to determine if refractions are covered under your plan.
- ALL INSURANCE INFORMATION (MEDICAL AND ROUTINE VISION) MUST BE PROVIDED 24HRS PRIOR TO YOUR APPOINTMENT TIME TO BE USED WITH EXAM OR MATERIALS.
- If an insurance plan is discovered after the patient has had services or placed a material order we are unable to back bill those services. In many cases exam coding and material manufacturing is determined by the insurance that will be filed. Due to this we are unable to change billing methods once services are provided which is why we require all insurance information in full prior to these services.
Featured Insurance Carriers
Don’t see your insurance company here? Please contact us and we’ll happily check to see if we can work with your insurance provider.
Pricing Information
Medical / Emergency Examinations
| CPT | Description | Fee |
| 99202 | Level 2 New Exam: Office visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. | $80.00 |
| 99203 | Level 3 New Exam: Office visit for the evaluation and management of a new patient, which requires a medically appropriate history and/or examination and a low level of medical decision making. | $120.00 |
| 99212 | Level 2 Established Exam: Office visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and straightforward medical decision making. | $65.00 |
| 99213 | Level 3 Established Exam: Office visit for the evaluation and management of an established patient, which requires a medically appropriate history and/or examination and a low level of medical decision making. | $90.00 |
| 65222 | Corneal Foreign Body Removal: In-office surgical procedure to remove a foreign body that has been identified to be on corneal tissue. | $90.00 |
| 65205 | Conjunctival Foreign Body Removal: In-office surgical procedure to remove a foreign body that has been identified to be on conjunctival tissue. | $75.00 |
| 99050 | After Hours Visit Fee: After hours’ service fee billed to all visits seen outside of our regular 8am-5pm Mon-Fri clinic hours. Includes emergency after hours’ phone consultations. Not billable to insurance. | $50.00 |
Routine Vision Examinations
| CPT | Description | Fee |
| 92014 | Established Comprehensive Exam: Comprehensive evaluation (established patient) of ocular structure and function to detect ocular diseases and determine if further testing is needed. | $125.00 |
| 92002 | New Intermediate Exam: Limited evaluation (new patient) of ocular structure and function to detect ocular diseases and determine if further testing is needed. | $105.00 |
| 92014 | Established Comprehensive Exam: Comprehensive evaluation (established patient) of ocular structure and function to detect ocular diseases and determine if further testing is needed. | $125.00 |
| 92012 | Established Intermediate Exam: Limited evaluation (established patient) of ocular structure and function to detect ocular diseases and determine if further testing is needed. | $105.00 |
| 92310 | CL Services: Prescription of optical and physical characteristics of and fitting of contact lens, with medical supervision of adaptation. Pricing varies depending on level on complexity. This fee is in addition to the comprehensive or intermediate fee. | $50.00 – $200.00 |
| S9986 | Optomap Screener: | $29.00 |
Special Testing
| CPT | Description | Fee |
| 92250 | Fundus Photography: one or more images taken of the retina (one or both eyes) with a fundus camera, with or without filters. | $90.00 |
| 92134 | OCT Optic Nerve: Scanning computerized ophthalmic diagnostic imaging of the optic nerve, one or both eyes. Includes interpretation and report. | $60.00 |
| 92133 | OCT Retina: Scanning computerized ophthalmic diagnostic imaging of the retina, one or both eyes. Includes interpretation and report. | $60.00 |
| 92025 | Corneal Topography: | $50.00 |
| 92083 | Diagnostic Visual Fields: Extensive testing of sensitivity of visual field, one or both eyes. Includes interpretation and report. | $85.00 |
| 92081 | Screening Visual Fields: Limited testing of sensitivity of visual field, one or both eyes. Includes interpretation and report. | $14.00 |
Surgical Procedures
| CPT | Description | Fee |
| 66821 | YAG Posterior Capsulotomy: YAG laser removal of posterior capsular opacity. Includes up to 90 days of care after surgery. | $400.00 |
| 66761 | YAG Iridotomy by Photocoagulation: | $300.00 |
Post-Operative Care
| CPT | Description | Fee |
| 66984 | Cataract Post-Operative Care: Care after cataract surgery in one eye that is coordinated between us and your surgeon. Includes up to 90 days of care after surgery date. | $225.00 |
| 66982 | Complex Cataract Post-Operative Care: Care after a complex cataract surgery in one eye that is coordinated between us and your surgeon. Includes up to 90 days of care after surgery date. | $240.00 |
Cataract Premium/Specialty Lens Co-Management
| CPT | Description | Fee |
| N/A | Cataract Specialty Lens Co-Management – Advanced Toric Specialty Lens: This fee covers the post cataract co-management of specialty toric lenses including but not limited to, Eyehance, Alcon and Bausch & Lomb. This fee will be discussed at the surgeon consultation for your cataract procedure. Patient responsibility. Not billable to insurance. | $150.00/Eye |
| N/A | Cataract Specialty Lens Co-Management – Multifocal Specialty Lens: This fee covers the post cataract co-management of specialty multifocal lenses including but not limited to, PanOptix, Vivity, Synergy, Crystalens options. This fee will be discussed at the surgeon consultation for your cataract procedure. Patient responsibility. Not billable to insurance. | $300.00/Eye |