CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Modoc Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $3,609
Cash Discount Price: $4,391
vs. Medicare Baseline: 1.53x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Modoc Medical Center is $3,609. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,391. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.53x the Medicare baseline. Located in 1111 N Nagle Street, Alturas, CA.

Cash / Self-Pay

$4,391

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,609

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: $4,391 (186%)

Insurance Median: $3,609 (153%)

Cash: $4,391 (186% of Medicare)

Ins. Median: $3,609 (153% 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
Adv Med Mgmt - All Plans	$1,005	43%
Medi-Cal	$1,005	43%
Medi-Cal 7/1/24	$1,005	43%
Blue Shield Comm - All Other Plans	$1,800	76%
Multiplan Wc	$2,240	95%
Ntwrks By Design Wc - All Plans	$2,334	99%
Integrated Hp Wc	$2,358	100%
Blue Shield Mcr Adv	$2,378	101%
Blue Shield Va	$2,378	101%
UnitedHealthcare	$2,378 - $4,171	101%
Tricare	$2,503	106%
Healthnet Mcr Adv	$2,528	107%
Partnership Hp - All Plans	$3,518	149%
Blue Shield Exch	$3,609	153%
Blue Cross Blue Shield	$3,610 - $4,011	153%
Carelon - All Plans	$4,011	170%
Corvel - All Plans	$4,127	175%
Aetna	$4,171	177%
Coventry/First Health - All Plans	$4,171	177%
Galaxy Health - All Plans	$4,171	177%
Healthnet Comm - All Other Plans	$4,171	177%
Hmn - All Plans	$4,171	177%
Integrated Hp - All Other Plans	$4,171	177%
Interplan - All Plans	$4,171	177%
Multiplan - All Other Plans	$4,171	177%
Superior Ca Ppo - All Plans	$4,171	177%

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 $4,391.
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 Modoc Medical Center 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.