Lasik eye surgery certainly is a premium procedure. Within a few minutes, lasik can eliminate your need for glasses and / or contact lenses. But as cool as this is, lasik isn't covered by insurances. Insurance companies are more than content with you wearing glasses to correct your vision. So lasik surgery ends up being an elective procedure with an out of pocket expense.
Lasik runs the spectrum of cost. But with many things in life, with lasik you get what you pay for. Cheaper costs with lasik come at the expense of quality and support; two things you don't want to pinch pennies on with your eyes. So what does lasik cost? You will be able to find lasik as cheap as $3,000 for two eyes or even $2,500 (not recommended). You can also find lasik that costs as much as $5,500 or rarely more. But the average cost for lasik for both eyes is around $4,500.
That money seems pretty steep. But nothing in medicine is cheap. And actually, lasik practices aren't running any massive profit margins; there are a lot of costs to lasik.
What's Involved In The Costs Of Lasik?
Direct Procedure Costs
The lasik procedure itself has expenses. Lasik lasers are quite sophisticated. These lasers are also extremely expensive to buy or lease; these are million dollar lasers! So each practice will have payments to pay off the laser. In addition for every lasik treatment performed with the laser, the manufacturers take a cut - called a "click fee". This fee ranges somewhere between the range of $500-$800 per eye. This fee varies based upon the type of lasik treatment being performed and can also vary due to the volume of the center.
Side note: there are a few older lasers which don't have any click fees. These lasers entered the market before the laser manufacturers realized that they could gain extra revenue from these fees. A few lasik surgeons will still use these lasers to save costs. The big caveat is that these lasers are old technology. There have been vast improvements in laser technology since these lasers entered the market. Do you really want to get your eyes treated with old technology?
How can lasik practices save on click fees? (other than using older lasers as described above). One way is to create the lasik flap with a blade (called a microkeratome) rather than a laser to create the lasik flap. Creating the lasik flap with a blade requires one purchase. As it's a blade, it's not run or controlled by a computer limiting its use. Can't put "click fees" on a blade. Again, this uses old technology. Lasik has progressed past the blade era.
A few of the notable improvements and benefits of using lasers to create the lasik flap:
- Able to do more shallow cuts and affect less of the cornea. This decreases the risk of the cornea becoming weaker over time (see also Is Lasik Safe?)
- Ability to create a 3D flap with lasers. This allows the lasik flap to better lock in place to the cornea. As a result, laser created lasik flaps are more secure
- Elimination of microkeratome cutting errors. Rarely, microkeratomes can create irregular cuts into the cornea. These cutting errors are bad. A "free cap" can happen if the microkeratome completely cuts the lasik flap away from the cornea; ie, it is no longer attached. A "button hole" is created if the microkeratome cut through the cornea leaves a giant hole in the middle of the lasik flap. None of these are good and means the procedure has to be aborted. These also have the potential for loss of vision depending on where it occurs and how it heals afterwards. These are best avoided by avoiding microkeratomes and sticking to laser-created flaps.
Rounding out the remaining fees for the lasik procedure itself includes the cost of the supplies and the cost of staffing & surgeon. These costs aren't too big. Lasik doesn't require tons of expensive supplies. It's a mix of disposable items such as gloves and tiny sponges used in lasik and instruments; and there aren't a ton of instruments. During a lasik procedure, there are typically two additional technicians in addition to the surgeon. One of these technicians runs the lasers while the other serves to pass the sterile instruments and supplies to the surgeon. These additional expenses add roughly $400-$500 to a bilateral lasik procedure.
So what is the cost just for the procedure itself? Including the laser costs, the material and staffing costs, we are already looking at $1,400 on the very low end to $2,200 on the high end (this price doesn't factor in cutting costs by using old lasers or microkeratomes during lasik). You can already start to see how some lasik prices are just unrealistically low.
Pre-Operative and Post-Operative Visits
Before lasik, there are a few typical visits. You must visit and determine whether you are a candidate for lasik. At this visit, the practice evaluates your prescription and scans of your cornea to determine if lasik would work for you. Occasionally they will dilate your eyes and check your eye health and further refine your dilated prescription at this visit. But if not, you will have another visit to perform this task.
Even after those initial visits, you will have a "visit" just before your lasik procedure where you have your prescription further refined and have a technician prepare you for surgery.
Lasik is a very hands-on process with multiple different involved people helping you out.
And this hands-on approach continues after the procedure as well. After a typical lasik case you will be seen the next day. You will also be seen one month out from the procedure and often one week as well. Beyond the one month mark, sometimes you are also seen at three months and further out. Sometimes these post-operative appointments are done by your regular eye doctor. Sometimes these appointments are done by the lasik provider. But either way, in each of these appointments, your eyes are evaluated by eye doctors to make sure your eyes are healing the way they should be.
These appointments are all included in the cost of your lasik procedure. Overall all these appointments make up approximately $800-$1200 in the cost of lasik.
Costs Of Running A Business
So we're up to $2,200 to $3,400 for a lasik procedure. So what makes up that remaining $800 to $2,100? It comes down to the costs of running a lasik practice.
There are two main things a lasik practice needs:
Property & equipment
First, you need a roof over your head. A portion of each lasik procedure goes towards paying the rent and utilities for the building. Rent and utilities can vary pretty wildly between location and size of the lasik practice. For this reason, lasik will be more expensive in an area where cost of living is higher and vice versa, lasik will be cheaper in an area where cost of living is lower.
But within the building is lots of equipment. I already talked about the lasers, but the practice will also use lots of diagnostic equipment, slit-lamp microscopes, computers, etc. General equipment for an ophthalmology practice isn't cheap. Typically to afford this equipment, the practice mixes buying used equipment vs taking on leasing agreements for new equipment. But even despite that, there are typically routine expenses which need to be paid.
The back office people
There are even more people that you don't even realize exist. All the people in the back office! These people take care of the more administrative tasks for lasik: scheduling appointments, answering phones. These important individuals make up your customer service. They allow for solid communication. They answer your questions. They are essential for having a good experience with lasik.
But in addition to these support roles. There a segment of the business dedicated to spreading the joys of lasik out to the community (the marketers). Without any marketing, lasik practices would die. For some practices, marketing takes a significant chunk of dollars. For some practices (such as if there isn't really any competition), marketing is less of an expense. But ultimately this is an expense that is factored into the pricing for lasik.
Lasik IS a business
Lastly, we don't want to forget that lasik is still a business. And all businesses work towards obtaining a profit for their investors. Is it the most important thing for the business? Typically no. But as such, a small part of the lasik price factors in profit for the lasik practice. However, the amount of profit from a lasik procedure is still limited by supply and demand. If a business tries to eek out too much profit and the prices becomes unaffordable, well then that business will get no patients. If the lasik price is too low and the business can't turn a profit, well than that business will either go OUT of business or there is no incentive to continue performing lasik. Everything eventually hits equilibrium.
How can you make lasik cheaper? Well, you can eliminate new technology. You can eliminate people behind the scenes and cut out good customer service. Either way those really aren't good options when you are having surgery on your eyes. While lasik can be expensive, there are often very good payment plans you can use to pay for the surgery. And while the cost can be high, the value you get from lasik can be pretty massive. Being able to see without glasses or contact lenses can be pretty life changing!
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