Cost of LASIK and Other Corrective Eye Surgery

LASIK prices differ widely from one provider to another and depend on many factors. The only universal standard is that LASIK and other refractive surgery prices are quoted per eye (as we do in this article).

Remember that one LASIK procedure equals only one eye even if both eyes are corrected on the same day. So the price quoted for a procedure doubles if you intend to have both eyes corrected.

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LASIK surgeons also might add extra charges for new technologies, including wavefront analysis for extra precise corrections (custom wavefront LASIK).

You also might be charged extra for IntraLase, a LASIK procedure in which a laser is used instead of a bladed instrument to create the flap on the front of the eye. In LASIK, this thin flap is lifted so that laser energy can be applied to shape the eye, and then replaced to serve as a type of natural bandage.

Also, there can be wide variation in what an advertised price will include. Beware of advertising that, for example, promises "LASIK from $500 per eye." Look for the fine print. Typically, only a few select people are actually eligible for LASIK at that price, because most eyes require more extensive correction or more follow-up after the surgery.

A leading industry analyst in 2007 said only 6.9 percent of conventional LASIK procedures cost less than $1,000 per eye. These procedures are performed with the less expensive options of bladed microkeratomes and conventional excimer lasers, not guided by wavefront analysis. Most customized wavefront procedures that also use laser-created flaps (IntraLase) cost from $1,000 to $2,500 per eye (see charts below).

When you deal with centers and surgeons that advertise LASIK surgery at bargain prices, you would be wise to ask plenty of questions related to what a procedure actually costs beyond what is advertised.

As an example, Florida's Attorney General in November 2005 announced a settlement with Lasik Vision Institute for allegedly misrepresenting the actual cost of eye surgeries as stated in the company's advertisements. One dispute in the case involved non-refundable deposits, even when an individual opted not to have surgery.

Based on these types of isolated incidents, make sure you clearly know what the total cost of the procedure will or could be, including surgeon and facility fees or any other extras. One advertised price represented as a "bargain" might include those types of extra costs, while another might not.

LASIK prices, after rising for several years, seemed to stabilize in 2006 and 2007. Industry sources report that the average LASIK price in late 2006 was about $1,950. In 2007, LASIK and laser-based procedures charged at a single price (no extra charges added on for new technologies) cost an average of $2,099 (see charts below).

In comparison, LASIK in 2002 was $1,550-$1,600; by October 2003 it had risen to $1,710; at the end of 2004, it was a little over $1,800; and in 2005 it was $1,965. These averages take into account procedures performed at surgeon-owned laser centers, institutions, and corporate laser centers. Also, keep in mind that earlier prices do not reflect new technologies of wavefront analysis and laser-created flaps, which have been adopted for widespread use only in recent years.

A leading multi-center LASIK provider, TLC Laser Eye Centers, reported an average per procedure fee of $2,000 in early 2007 and 2006. In 2002, the average procedure fee was $1,800. In the fourth quarter of 2004, TLC's average price was $1,957. In 2005 and into 2006 and 2007, however, it has remained around $2,000. At TLC, an extra charge of $350 to $500 per eye is added for wavefront analysis combined with IntraLase.

Another national provider, LasikPlus, reported in 2007 that its per-procedure prices at various centers had increased about 2 percent, from $1,344 in 2005 to $1,387 in 2006.

Following is a chart of average LASIK prices, per eye, as reported in 2007 by a leading industry analyst.

Average LASIK prices rose for several years partly because an increasing number of LASIK procedures:

• are "custom" or "wavefront" LASIK, which is often more expensive than traditional LASIK. (See below for custom LASIK pricing, and refer to our custom wavefront LASIK article for an explanation of the procedure.)
   
• use Intralase technology, which increases procedure cost (see charts below).
   

More expensive technology is being used more often in LASIK procedures:

LASIK with IntraLase, a procedure in which the surgeon creates the LASIK flap with a laser rather than a microkeratome, typically costs more than traditional LASIK. IntraLase reported in early 2007 that the average extra cost per eye added onto a LASIK procedure for use of IntraLase is $394. The price is higher for IntraLase because surgeons must cover the cost for the system; those surgeons who use it cite studies that show patients have fewer flap complications, need fewer retreatments, and have a greater likelihood of achieving 20/20 acuity or better. [See also: Blade Versus Bladeless LASIK Debate.]

Custom LASIK, which involves using wavefront technology to measure and map the aberrations and vision problems that occur when the eye fails to correctly focus light rays, also usually costs more than traditional LASIK. Some eye surgeons don't charge a separate fee for new technologies used in LASIK, and instead quote their price as a single fee. According to industry sources, about 40 percent of LASIK surgeons used a single-price approach as of early 2007.

We found several sources for pricing information:

• In 2007, AllAboutVision.com commissioned a report from a leading industry analyst who found that wavefront LASIK combined with IntraLase costs an average of $2,357, compared with $1,694 for conventional LASIK. This is a price difference of $663 per eye between the two procedures.
   
• A March 2007 TLC Laser Eye Centers report to the U.S. Securities and Exchange Commission (SEC) said the company's range of charges was $350 to $500 extra per eye for wavefront analysis (custom LASIK) combined with IntraLase. For a three-month period covering July through September, TLC in its late 2007 quarterly report noted increased refractive surgery center revenues of 13 percent compared with the same three-month period the previous year. The number of procedures grew at a rate of 7 percent during the same time period. The report says the extra increase in revenues was due to people opting for higher-priced procedures during 2007.
   
• TruVision Laser Eye Centers in 2007 advertised conventional LASIK at $895 per eye, and wavefront LASIK at $1,295 per eye, for a price difference of $400. Bladeless LASIK (IntraLase) was advertised in late 2007 at $1,895 per eye, for an additional cost above conventional wavefront LASIK of $600 per eye.
   

Below are typical prices, per eye, for other types of refractive eye surgery. As with LASIK, the prices vary based on many factors, including your individual prescription, where you live, and which surgeon you choose.

• CK: $1,500 to $2,000
• PRK, Epi-LASIK and LASEK: about the same as LASIK
• Refractive Lens Exchange (RLE): $2,500 to $4,500 per eye or more, depending on extra costs such as facility fees.

One reason fees vary widely is that different providers perform varying levels of preoperative testing. Since proper screening can avoid problems, it's important to determine if appropriate testing is included in a quoted price.

There's also a wide variation in the cost of equipment used for testing and surgery. Technologies for eye tracking, tear film analysis, and measurements of corneal thickness, corneal topography and pupil size, as well as the laser itself, are available at various price points; and can be reflected in the procedure fee.

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Refractive surgery fees cover a variety of costs, including:

• Purchase or lease and maintenance of the laser, microkeratome, corneal ring segments, and/or other devices used in the procedure;
  
• A $100 to $150 per eye royalty fee to the excimer laser manufacturer, who must recoup the cost to develop the machine;
  
• A $145 to $250 per eye royalty fee if it is a custom procedure, depending on the laser manufacturer;
  
• Gowns, masks, gloves and other items for keeping the operation sterile;
  
• Microkeratome blades, surgical solutions and medications used during the surgery;
  
• With IntraLase, disposable equipment that includes a metal cone and glass lens connecting the laser to the treated eye;
  
• Overhead for the surgery center, which includes office and surgical staff salaries and benefits, rent, office equipment, and office administration;
  
• Patient acquisition costs, which include advertising, seminars, and fees paid to other eyecare practitioners for comanagement;
  
• Insurance;
  
• And, especially if the surgeon is not on staff, his or her fee.

Also included in most fees are the pre-op evaluation meeting, comprehensive eye examination (including technician time and equipment costs), follow-up office visits and tests, plus any standard medications.

Many surgeons also offer free "enhancement" surgery if it is warranted. Often a team of doctors reviews your case to determine this, and their time is included in the fee.

When discussing fees with your surgeon, ask:

• What is included?
  
• What is not included?
  
• What will I have to pay for if complications occur or enhancement surgery becomes necessary?
  
• How much do prescription medications (such as anti-inflammatories or painkillers) cost?
  
• If I require temporary contact lenses or glasses after the procedure, how much will they cost?
  
• How many follow-up visits will I need to make, and at what cost?

Most vision insurance plans don't cover refractive surgery because they consider it cosmetic. However, some employers make arrangements with a given LASIK center (or refractive surgery center) for a special price. Also, you may qualify for a tax deduction for refractive surgery, so check with an accountant.

You may be tempted to choose a surgeon based only on the fee charged, but that is not smart. What is better is to choose the best surgeon you can find and then, if you need it, get the most affordable financing you can. Think of it this way: If you choose Surgeon A who charges $400 less than Surgeon B, but you know that Surgeon B has more experience, you are risking your vision for the sake of $1 per day over the course of 13 months. Is the higher risk really worth the monetary savings?

Financing is available for LASIK and other vision surgeries. Several financing companies specialize in elective procedures and offer plans with fixed rates and long-term payments. Most LASIK surgery centers and private medical practices work with one of these companies to offer a financing plan to their patients.

Note that some large companies, such as Microsoft Corp., are now offering subsidized health plans that cover at least part of LASIK costs. If you work for a major company, ask about possible benefits that might cover elective corrective eye surgery procedures.