CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Adventist Health Tehachapi Valley

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $683
Cash Discount Price: $512
vs. Medicare Baseline: 0.29x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Adventist Health Tehachapi Valley is $683. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $512. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.29x the Medicare baseline. Located in 1100 Magellan, Tehachapi, CA.

Cash / Self-Pay

$512

Average discount available for prompt cash payment at this facility.

Insurance Median

$683

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: $512 (22%)

Insurance Median: $683 (29%)

Cash: $512 (22% of Medicare)

Ins. Median: $683 (29% 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
Healthnet Mcare	$480	20%
Tricare	$480	20%
UnitedHealthcare	$480 - $704	20%
Universal Ipa Mcr Adv Op/Profee Only-All Other Pla	$480	20%
Network Providers- All Plans	$523	22%
Ah Employee Health Plan - All Plans	$528	22%
Oscar Health Plan- All Plans	$552	23%
Coventry- All Plans	$576	24%
Aetna	$658	28%
Western Grwrs/Pinnacle - All Plans	$667	28%
Healthnet- All Other Plans	$699	30%
Centivo - All Plans	$720	31%
Cigna	$743	32%
Medi-Cal	$1,005	43%
Universal Ipa Mcal Op/Profee Only	$1,005	43%
Blue Shield Epn- All Other Plans	$1,053	45%
Blue Shield Non-Epn	$1,113	47%
Blue Cross Blue Shield	$1,385	59%

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 $512.
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 Tehachapi Valley 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.