CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Saint Agnes Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $3,413
Cash Discount Price: $7,818
vs. Medicare Baseline: 1.45x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Saint Agnes Medical Center is $3,413. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,818. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.45x the Medicare baseline. Located in 1303 E Herndon Ave, Fresno, CA.

Cash / Self-Pay

$7,818

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,413

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: $7,818 (332%)

Insurance Median: $3,413 (145%)

Cash: $7,818 (332% of Medicare)

Ins. Median: $3,413 (145% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Medi-Cal Healthnet	$174 - $181	7%
Aetna	$2,909	123%
Blue Cross Blue Shield	$2,909 - $10,943	123%
Humana	$2,909 - $3,057	123%
UnitedHealthcare	$2,967 - $7,029	126%
Medicare (plans)	$3,030 - $3,057	129%
Welbe Health	$3,054	130%
Align Senior Care	$3,413	145%
Blue Shield - Ca	$3,758 - $10,943	159%
Kaiser Permanente	$5,194	220%
Advantek Central Usd	$6,155	261%
Geha	$7,029	298%
Blue Benefit Administrators Of Massachusetts	$10,943	464%
Blue Care Network	$10,943	464%
Blue Distinction Transplant	$10,943	464%
Blue Shield - Id (Regence)	$10,943	464%
Blue Shield - Ny Highmark Northeastern	$10,943	464%
Blue Shield - Ny Highmark Western	$10,943	464%
Blue Shield - Pa (Highmark)	$10,943	464%
Blue Shield - Wa (Regence)	$10,943	464%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $7,818.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 66984.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Saint Agnes Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 66984.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.