CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Encino Hospital Medical Center

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 Encino Hospital Medical Center 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 16237 Ventura Blvd, Encino, 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
Aids Healthcare Foundation $1,442 - $3,013 61%
Blue Shield Of Promise $1,442 - $2,954 61%
Health Net Of Ca $1,442 - $4,312 61%
La Care Health Plan $1,442 - $2,954 61%
Molina $1,442 - $2,954 61%
Traditional Medi-Cal $1,442 61%
Blue Cross Blue Shield $1,514 64%
Alignment $2,954 125%
Blue Shield Of Ca, Va $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%
Brand New Day $2,983 - $4,431 127%
Imperial Health Plan Ca $3,131 133%
Corvel $3,697 157%
Zelis Healthcare $3,697 157%
Aetna $3,774 160%
Americas Choice Provider Network $3,774 160%
Multiplan $3,774 160%
Prime Health Services, Inc. $3,774 160%
Three Rivers $3,774 160%
Healthsmart Preferred Care Network $3,813 162%
Provider Select $3,852 163%
Provider Network Of America $3,891 165%
Workers Comp $3,891 165%
Employer Direct Healthcare $4,135 175%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 16237 Ventura Blvd, Encino, CA 91436
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals