What Goes Into the Cost of LASIK?

October 08, 2019

For this article, Dr. Bowers explores what goes into the overall cost of LASIK.

Why does LASIK cost so much? And why do some places offer deep discounts and others do not?

I am sometimes asked why the cost of LASIK is so high. At the same time patients will bring me an ad for LASIK promoting an unusually low cost LASIK, such as a $900 promotion. Why the high, and sometimes quite variable, cost when it comes to LASIK surgery? LASIK candidates who are in the midst of investigating this wonderful procedure need to be aware that LASIK is heavily ‘market driven’ in an effort to appeal to potential patients. This means LASIK providers have to find creative ways to attract patients and ultimately convert them into patients who follow through with surgery. Let’s break it down further into what factors can also affect and even drive up the cost while also looking at cost discrepancies.

First, the cost of lasers remain a significant factor in driving up the cost of LASIK in a way that is hard for any surgeon to avoid. At Piedmont Eye Center, we utilize two separate lasers on all of our LASIK patients. An Intralase™ laser that creates the LASIK flap can cost around $300,000 and the VISX™ excimer laser, which does the actual treatment, can cost as much as $500,000.

As we all know, technology is ever changing and sometimes this adds cost as surgeons try to keep their lasers current with the latest software and hardware updates. Although it is not required for surgeons to pay extra for getting these updates, those that do are committed to staying current with the very latest technology even despite the added cost. For example, we elected years ago to upgrade and purchase Iris Registration™ software to enable more precise treatments; something that cost us around $50,000. It was an optional upgrade but one that we felt was in our patients’ best interest. Just months ago, we elected to purchase the newly released and optional upgrade called iDesign™, which improves treatment precision even further, yet costs us $60,000 to acquire. We are proud to be the first in the area to have it. Many surgeons also take part in a preventative maintenance program for their lasers which provides annual, or sometimes more frequent, checks to make sure the laser is functioning properly and to catch potential problems before they occur. This too can cost as much as $50,000 annually, but for surgeons committed to providing the highest level of care, we feel it is a requirement.

Additionally, these highly-sophisticated lasers are fussy and can be affected by such things as temperature and humidity variations. Housing these lasers in an environmentally controlled laser suite is ideal and something we feel is important, yet does add to the cost of caring for these devices. For surgeons trying to avoid the cost of owning a laser, there are even options to ‘rent’ what’s called a roll-on / roll-off laser; one that is brought in on a truck, used to treat, and then hauled away to the next site. For obvious reasons, we elected not to do this but to own our laser and house it in an environmentally-controlled laser suite.

There is yet another cost most patients are unaware of. Even though we own the lasers outright, we have to pay a small per-treatment fee to the laser company for any treatment done. This fee goes back to the company to help with research and development. Not every company requires it but Advanced Medical Optics (AMO), who supplies our lasers, requires it. We are comfortable in knowing they are committed to finding new ways to improve outcomes.

Certainly, the ancillary costs come into play as well, such as supplies and the use of highly trained technical staff. At Piedmont Eye Center, I usually have four certified and experienced ophthalmic technicians assisting me on every patient.

So, it’s easy to see why LASIK can cost so much. But now for the next question: How are some providers able to offer promotions such as a $900 special? Often, these are chain LASIK centers that try to maintain a very high-volume caseload, meaning patients are literally scheduled back-to-back so the lower profit-per-case can add up over time. This appeals to some patients to get the cheapest LASIK possible. We are not that kind of facility, nor do we desire to be a high-volume assembly line, which can often be associated with less personable attention and care. Often times there are hidden costs such as the initial examination fee, prescription medications, and charges for any necessary touch ups. The other side to this is that the low cost ‘special’ could be an entry level treatment which may not include the latest upgrades like custom Wavefront-Guided treatment. Once patients are in the door and realize they want ‘the best’ option, the cost is often very comparable to any other provider. By then, patients may feel obligated to pay the added difference. The saying is still true in many cases; you really do get what you pay for. Our advice is that if the cost seems too good to be true then question it and find out why and get a second opinion.

Patients need to be aware of hidden charges and one item that is often charged for by providers is the LASIK evaluation itself. We have never charged for the comprehensive LASIK exam and our evaluation is more than just a screening 15 minute visit. Patients typically are in our office for two hours undergoing testing and a comprehensive dilated exam performed by myself on every case. Every patient leaves knowing all of their options and having ample time with the surgeon to answer questions and address concerns specific to them. It’s really the only way a patient can get all the information they need to make an informed decision. Patients from other practices often come to see us for that free ‘second-opinion’ even when tentatively scheduled elsewhere. We find that many choose to stay when they experience the completeness of our examination and personal, ‘no-pressure’, attention. In any case, we just want patients to be informed without feeling obligated in any way.

Regardless of who is doing your surgery, make sure you do your homework and ask the tough questions about cost, keeping current with technology and, above all, making sure your experienced surgeon addresses all of you questions and concerns personally. You owe it to yourself to have all the information as it relates to you and your vision.

-Darin Bowers, MD

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