About 15–25% of people who want LASIK can’t have it — and the only way to find out which group you’re in is the candidacy evaluation. It’s one of the more consequential medical appointments you’ll have, and also one where pricing varies surprisingly: some clinics charge nothing, others bill $250 upfront. Knowing what you’re paying for (and what shortcuts look like) matters before you book.
Free Consultation vs. Paid Pre-Op Workup
“Free LASIK consultation” is marketing language. There’s an important clinical distinction between that and a real candidacy workup.
Free LASIK consultation (most chain centers and many private practices): Usually automated refraction, a brief slit-lamp look, and a conversation about your goals. It answers “are you roughly a candidate?” but doesn’t produce the measurements actually needed to plan surgery or rule out contraindications.
Full candidacy workup / pre-op evaluation: This is the medically meaningful appointment. Corneal topography, pachymetry, wavefront aberrometry, pupil measurement under dim light, tear film assessment, dilated fundus exam. Takes 60–90 minutes. May cost $150–$300 if billed separately from the surgical fee.
| Exam Type | Typical Cost |
|---|---|
| Free initial LASIK consultation | $0 |
| Paid candidacy consultation (private practices) | $100–$250 |
| Full pre-op workup if billed separately | $150–$300 |
| Corneal topography alone | $50–$100 |
| Wavefront aberrometry alone | $75–$150 |
| Dilated exam component | $50–$100 |
Many practices bundle the full pre-op workup into the surgical fee — no separate charge if you proceed. If you don’t proceed with surgery, you may owe $150–$300 for the clinical testing. Ask about this structure upfront.
What Tests Are Actually Performed (and Why They Matter)
Corneal topography maps the shape of your cornea across thousands of points. Irregular topography — signs of keratoconus or forme fruste keratoconus — is an absolute contraindication for LASIK. This one test disqualifies 10–15% of interested patients. It cannot be skipped.
Pachymetry measures corneal thickness. LASIK reshapes the cornea by removing tissue, and a minimum safe stromal bed of roughly 250 microns must remain after the flap and ablation. Thin corneas eliminate LASIK as an option entirely.
Wavefront aberrometry captures the optical imperfections of your entire visual system, not just your basic prescription. This data programs the excimer laser for custom-guided ablation.
Pupil diameter under low light matters because unusually large pupils — 8mm or wider — may increase the risk of halos and starbursts at night after surgery, where the ablation zone doesn’t fully cover the dilated pupil.
Tear film assessment identifies dry eye, which can disqualify patients outright or require months of treatment before surgery becomes safe.
A few things that directly affect your exam results:
- Your current glasses prescription — or just bring your glasses
- Contact lenses must be out beforehand: soft lenses out for at least 2 weeks, gas-permeable lenses out for 3–4 weeks (contacts alter corneal shape, which throws off topography measurements)
- Full medication list — many drugs affect dry eye and post-op healing
- Specific questions about your lifestyle, hobbies, and work environment — these factor into which procedure is right
- Your health insurance card — consultation fees sometimes apply toward your deductible
What Can Disqualify You
Roughly 15–25% of LASIK hopefuls aren’t suitable candidates. The most common disqualifying factors:
- Prescription changed by more than 0.5D in the past year (instability)
- Corneas too thin for safe ablation
- Signs of keratoconus or corneal ectasia
- Significant dry eye syndrome
- Extreme refractive errors (very high myopia, hyperopia, or astigmatism beyond safe ablation range)
- Certain autoimmune diseases that impair healing
- Pregnancy (which temporarily alters corneal shape and prescription)
If the evaluation rules you out, it’s not wasted time or money. Knowing you’re not a safe candidate is important information. The alternative — proceeding without proper screening — is how serious complications happen.
If a LASIK clinic tells you you’re a candidate after a 15-minute appointment with no topography, no pachymetry, and no dilated exam — leave. A legitimate candidacy evaluation takes at least 60–90 minutes with comprehensive testing. Shortcuts in the pre-op workup are shortcuts in patient safety. The ASCRS guidelines are explicit about the minimum testing required.
See also: LASIK Eye Surgery Cost for procedure pricing once you’re cleared, and PRK Surgery Cost if LASIK isn’t right for your corneas.
Bottom Line
Expect the LASIK candidacy process to cost $0–$300 depending on how the clinic prices it. Most chains absorb the cost into the surgical fee or offer it free upfront. Private practices may charge $150–$250 for a full clinical workup. Either way, the evaluation is not a step to rush or skip — it’s what keeps you out of the small percentage of patients who end up with a bad outcome because the right screening wasn’t done.