CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Watsonville Community Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $1,442
Cash Discount Price: $2,873
vs. Medicare Baseline: 0.61x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Watsonville Community Hospital is $1,442. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,873. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.61x the Medicare baseline. Located in 75 Nielson Street, Watsonville, CA.

Cash / Self-Pay

$2,873

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,442

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: $2,873 (122%)

Insurance Median: $1,442 (61%)

Cash: $2,873 (122% of Medicare)

Ins. Median: $1,442 (61% 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
California Childrens Srvs	$1,268 - $1,442	54%
Ccs/Monterey County	$1,268 - $1,442	54%
Healthy Families	$1,268 - $1,442	54%
Medi-Cal E.R.	$1,268 - $1,442	54%
Medi-Cal/Eds	$1,268 - $1,442	54%
Medicaid / KanCare	$1,268 - $1,442	54%
Well Path	$1,268 - $1,442	54%
Alliance/Sccho	$1,860 - $2,472	79%
Aetna	$8,858	376%
Blue Cross Blue Shield	$12,053	511%
Calif Ironworkers Field	$12,053	511%
Carpenters H&W Trust	$12,053	511%
City Of Wats/Pinnacle Clm	$12,053	511%
Claims Management Wc	$12,053	511%
Delta Health Systems	$12,053	511%
Laborers Health & Welfare	$12,053	511%
Monterey Bay Pub Emp Trst	$12,053	511%
Operating Engineers	$12,053	511%
Pinnacle Claims Tpa/Bc	$12,053	511%
Robert Kennedy/Ccn	$12,053	511%
Sheet Metal Workers	$12,053	511%
State Compensation Fund	$12,053	511%
Teamsters Benefit Trust	$12,053	511%
Western Growers Trust/Bc	$12,053	511%

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 $2,873.
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 Watsonville Community Hospital 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.