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The Cost of LASIK Surgery

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Since the excimer laser was first approved by the FDA in 1995 for laser vision correction surgery (PRK), there has been a lot of variation in its cost, and a lot of discussion about its cost. Contrary to common belief, consumers did not immediately rush to have laser vision correction surgery performed, and national surgery numbers were far below what industry experts had projected. Although ophthalmologists rushed to offer it as quickly as they could, consumers were slow to respond. Cost was one perceived barrier.

Early LASIK Costs

To stimulate surgical volume and capture early market share, some eye surgeons offered discounted or “bargain basement” prices. Some were a little cavalier about patient screening, in the interests of performing as many LASIK procedures as they could. Some LASIK centers were described as “factories”, processing quantities of patients with speed, while cutting some corners to keep costs down.

Examples of such economizing were:
Not sterilizing equipment often enough
Not changing the microkeratome blade (used to create the LASIK flap) for each new patient
Not recalibrating the laser often enough
Not studying patient medical histories carefully enough
Reducing doctor-patient contact to allow practices to see more patients
Using imported equipment that was made more cheaply than FDA-approved equipment
Using second-hand equipment

The practice of cutting corners was quickly curbed when many previous LASIK patients began having severe eye or vision problems. Many had not been good candidates for LASIK, and should never have had it done. There were such problems as Dry Eye Syndrome, Keratoconus, eye infections, and poor vision arising from corneal flap problems.

What Does the LASIK Cost Include?

When considering the cost of LASIK, it’s important to remember that prices are quoted per eye. Therefore, if you need LASIKperformed in both eyes, which most people do, you must double that figure.

Since 1995, LASIK technology has improved vastly and there are more choices of exactly how your vision correction will be performed. Besides the original procedure (PRK) and what is now known as Traditional LASIK, there are also:
Custom LASIK
LASEK
Epi-LASIK
IntraLase (All-laser LASIK)

This means that there are more treatment elements and options, which may or may not be included in the advertised price. When you see LASIK advertised at prices like $499 per eye, or even $299 per eye, be sure to learn exactly what you would get for that price, and if you are a candidate for that price. Ask for a written statement of all services included. Extra items might be things like:
Cost of anesthetic
Surgeon’s fee
Facility fee
Cost of initial examination
Cost of follow-up appointments
Cost of any enhancement surgeries to improve initial results

Variations in the Average Price

According to testimony given in July, 2006 to the U.S. House Ways and Means Health Subcommittee hearing on Price Transparency, the average price mid-2005 to mid-2006 was about $2,000 per eye, and “only about 3 percent of LASIK procedures actually cost less than a thousand dollars an eye.” This was in spite of the many advertised prices of $299 per eye.

CareCredit, a financing company which offers low-interest or no-interest loans for LASIK, currently states on its website that “… average costs typically range anywhere from $1,300 to $2,570 per eye.” That is a wide variation and there are good reasons for it.

LASIK costs will vary for each person. That is because each person’s eye conditions and requirements are individual. If you have only mild myopia with little astigmatism, your procedure is simpler to perform than one for a person with severe myopia and severe astigmatism.
LASIK costs will vary depending on what procedure you have. A traditional procedure uses simpler technology and will therefore cost less. IntraLase uses a second laser to make the corneal flap, and therefore will cost a bit more. If you have the most up-to-date Custom LASIK, the technology is far more sophisticated and your cost will be higher. You will be getting more for your money however, as Wavefront vision correction is entirely customized to each of your two eyes and there are fewer side effects.
Vision correction costs vary according to the local market. Some areas have more demand and more competition among surgeons, which could lower the price. On the other hand, competition may prompt eye surgeons to buy the latest and best equipment, which might raise the price.

Items Contributing to a Surgeon’s Price

When an ophthalmologist determines what to charge for LASIK, he must cover his costs, which may include:
Purchase and maintenance of equipment
Royalty fees to the manufacturer of the equipment
Disposable materials such as gloves, masks, gowns, and one-use-only sterile items
Cost to him of medications, surgical solutions, and microkeratome blades
Rent for his premises
Salaries to his staff
Advertising costs
Website costs
Post-surgery enhancements for some patients
Utility bills

This is all in addition to paying himself for his own time spent on meeting with new patients, qualifying them as good candidates, performing the surgeries, performing any subsequent enhancements necessary, and following up to check on each patient’s progress afterwards.

Insurance
Many vision insurance plans classify LASIK as a cosmetic procedure, and therefore don’t cover it. Some employers have a relationship with a particular ophthalmologist who offers a discount to the employees. If your employer does not have such a relationship, perhaps you could suggest it.

Medicare and Medicaid do not cover LASIK, but can help with eye emergencies, eye diseases such as glaucoma and cataracts, and with eye glasses, contact lenses, and eye exams.

Questions to Ask When Discussing Costs

There is no consistent way that LASIK providers package their services. So to choose the best ophthalmologist, schedule consultations with several eye surgeons in your area. Consultations are typically free, so do as much comparison shopping as you want and ask lots of questions.
What is included in the price per eye?
What is not included?
If you write me any prescriptions, what would those costs be?
How many follow-up visits would there be, and are those costs included?
What complications might arise in my case and would further treatments be an extra cost?

Choose Wisely For the Sake of Your Eyes

LASIK is not an emergency procedure, so you have time to do your homework. For the sake of your own best eyesight and eye health, make the quality of your eye surgeon a higher priority than the cost of your procedure.

If you choose an inexperienced or corner-cutting eye doctor and something goes wrong, how will you feel about your choice then? Remember that all surgeries bring some attendant risks and a perfect outcome can never be guaranteed. So you need a fully-qualified doctor who stays up to date, attends personally to your preparation, surgery, and follow-up care, and answers your questions honestly.

The wise course of action is to take time in choosing that best possible eye surgeon, and then to trust that his or her price is fair and competitive.

---Jennifer Kimberley

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