CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Adventist Health Reedley

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $478
Cash Discount Price: $360
vs. Medicare Baseline: 0.20x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Adventist Health Reedley is $478. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $360. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.20x the Medicare baseline. Located in 372 W Cypress Ave, Reedley, CA.

Cash / Self-Pay

$360

Average discount available for prompt cash payment at this facility.

Insurance Median

$478

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: $360 (15%)

Insurance Median: $478 (20%)

Cash: $360 (15% of Medicare)

Ins. Median: $478 (20% 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
Bc Mcal	$125	5%
Cal Viva Hlth Mcal - All Plans	$125	5%
Central Ca Alliance Mcal Profee Only	$125	5%
Dignity Mcal Op/Profee Only-All Other Plans	$125	5%
Medi-Cal	$125	5%
Upn Mcal Profee Only-All Other Plans	$125	5%
Kern Health Systems Mcal-All Plans	$156	7%
Central Ca Alliance Ccs Profee Only	$188	8%
Central Ca Alliance Comm Profee Only - All Other P	$188	8%
Central Ca Alliance Chdp Profee Only	$250	11%
Blue Shield Mcare	$478	20%
Fhcn Pace Mcr Adv-All Plans	$478	20%
Lasalle Med Assoc Profee Only - All Plans	$478	20%
Sante Ipa Mcal/Mcare Hmo Profee Only	$478	20%
Tricare	$478	20%
UnitedHealthcare	$478 - $704	20%
Upn Mcr Adv Profee Only	$478	20%
Ah Employee Health Plan - All Plans	$526	22%
Community Care Ipa Mcal-All Plans	$574	24%
Sante Ipa Hmo Profee Only - All Other Plans	$574	24%
Aetna	$621	26%
Kaiser - All Other Plans	$645	27%
Kaiser Mcr Adv	$645	27%
Western Growers/Pinnacle- All Plans	$664	28%
Healthnet- All Other Plans	$696	30%
Cigna	$743	32%
Blue Shield Epn - All Other Plans	$1,053	45%
Blue Shield Non Epn	$1,113	47%
Blue Cross Blue Shield	$1,370	58%
Physicians Med Group Op/Profee Only- All Plans	$1,518	64%

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 $360.
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 Adventist Health Reedley 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.