CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Adventist Health Lodi Memorial

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $550
Cash Discount Price: $133
vs. Medicare Baseline: 0.23x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Adventist Health Lodi Memorial is $550. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $133. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.23x the Medicare baseline. Located in 975 S Fairmont Avenue, Lodi, CA.

Cash / Self-Pay

$133

Average discount available for prompt cash payment at this facility.

Insurance Median

$550

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: $133 (6%)

Insurance Median: $550 (23%)

Cash: $133 (6% of Medicare)

Ins. Median: $550 (23% 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%
Celtic Ins Company - All Plans	$125	5%
Kaiser Mcal	$125	5%
Medi-Cal	$125	5%
Hp Mcal Pro Fee	$138	6%
Healthnet Mcal	$150	6%
Hp Of San Joaquin Mcal	$150	6%
Alignment Health Plan (Ahp)-All Plans	$478	20%
Blue Shield Mcare Adv	$478	20%
Healthnet Mcare	$478	20%
Hp Of San Joaquin Mcr Adv	$478	20%
Humana	$478	20%
Knnex Health - All Plans	$478	20%
Tricare	$478	20%
UnitedHealthcare	$478 - $704	20%
Hp Healthy Kids Pro Fee	$502	21%
Ah Employee Health Plan - All Plans	$526	22%
First Health- All Plans	$574	24%
Beech Street- All Plans	$621	26%
Hp Of San Joaquin Ppo - All Other Plans	$621	26%
Multiplan- All Plans	$621	26%
Kaiser Commercial - All Other Plans	$645	27%
Kaiser Mcr Adv	$645	27%
Networks By Design- All Plans	$645	27%
Western Growers- All Plans	$684	29%
Healthnet- All Other Plans	$696	30%
Cigna	$743	32%
Aetna	$859	36%
Blue Shield Epn - All Other Plans	$1,053	45%
Blue Shield Non-Epn	$1,113	47%
Blue Cross Blue Shield	$1,370	58%

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 $133.
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 Lodi Memorial 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.