CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Santa Clara Valley Medical Center

Billing Code: 66984 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$2,198

about 0.9× the $2,358 Medicare rate · typically $792–$4,932

modeled estimate · not a bill or quote

What this hospital charges insurers

$849

Below the fair price — a good deal

about $1,349 under the fair price · 0.4× Medicare

Medicare pays $2,358 Fair price $2,198 This hospital $849 Cash price $5,606 Hospital's list price $8,008

How we calculate the fair BaseRate →

How this hospital compares to other CA hospitals

Highest price of the 9 CA hospitals we have prices for — worth calling around.

Cheapest $478 Priciest $849

Black dot = this hospital, among the 9 CA hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Cataract surgery with lens implant is about $2,198 (about 0.9× the $2,358 Medicare rate). Santa Clara Valley Medical Center charges insurers about $849, or about $5,606 in cash — below the fair price — a good deal. Located in San Jose, CA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$804	34%
Blue Cross Blue Shieldmajor	$1,326 - $12,073	56%
Aetnamajor	$849	36%
Cignamajor	$897 - $4,268	38%
Health Net	$670	28%
+ 2 smaller / regional plans	$670 - $2,076

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 5,606), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 66984.

Insurance Before you use insurance

Call your insurance company to confirm Santa Clara Valley Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 66984.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Santa Clara Valley Medical Center

Compare: Cataract surgery with lens implant at other CA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.