CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Paradise Valley Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 66984
  • Insurance Median: $2,954
  • Cash Discount Price: $2,953
  • vs. Medicare Baseline: 1.25x Medicare
The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Paradise Valley Hospital is $2,954. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,953. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.25x the Medicare baseline. Located in 2400 East 4Th St, National City, CA.
Cash / Self-Pay
$2,953

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,954

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$2,357.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $2,357.81 (100%)
Cash / Self-Pay: $2,953 (125%)
Insurance Median: $2,954 (125%)
Cash: $2,953 (125% of Medicare)
Ins. Median: $2,954 (125% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $2,357.81 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $1,442 - $3,774 61%
Blue Sheid Of Promise $1,442 61%
County Of San Diego $1,442 61%
Golden Physicians Medical Group $1,442 - $3,692 61%
Health Excel Ins $1,442 - $2,954 61%
Heritage Provider Netwrok $1,442 - $3,840 61%
Molina $1,442 - $2,954 61%
Traditional Medi-Cal $1,442 61%
UnitedHealthcare $1,442 - $2,954 61%
Health Net Of Ca $1,543 - $4,312 65%
Community Health Group $1,730 - $2,954 73%
Blue Shield Of Ca, Va $2,954 125%
Ca Foundation For Medical Care $2,954 125%
Central Health $2,954 125%
Choice Physicians Network $2,954 125%
Clever Care Of Golden State, Inc $2,954 125%
Managed Health Network $2,954 125%
Medicare (plans) $2,954 125%
Renal Payer Solutions $2,954 125%
Tricare $2,954 125%
Usa Senior Care Network $2,954 125%
Verda Health Plan $2,954 125%
Brand New Day $2,983 - $4,431 127%
Imperial Health Plan Of Ca $3,131 133%
Health Net Federal Service (Cdcr) $3,692 157%
Veterans Evaluation Services $3,692 157%
Worker Comp $3,891 165%
Integrated Medical Solutions $3,899 165%
Ca Dept Of Correction & Rehab $4,135 175%
Employer Direct Healthcare $4,135 175%
Naphcare $4,578 - $5,907 194%
Scripps Health $5,021 213%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2400 East 4Th St, National City, CA 91950
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals