CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Saint Mary's Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $6,873
Cash Discount Price: $7,555
vs. Medicare Baseline: 2.91x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Saint Mary's Hospital is $6,873. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,555. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 2.91x the Medicare baseline. Located in 56 Franklin Street, Waterbury, CT.

Cash / Self-Pay

$7,555

Average discount available for prompt cash payment at this facility.

Insurance Median

$6,873

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: $7,555 (320%)

Insurance Median: $6,873 (291%)

Cash: $7,555 (320% of Medicare)

Ins. Median: $6,873 (291% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 291% of the Medicare baseline (a markup of 191%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Connecticut Dept of Correction	$2,555	108%
Aetna	$2,711	115%
Blue Cross Blue Shield	$2,711 - $8,206	115%
Medicare (plans)	$2,711 - $2,822	115%
UnitedHealthcare	$2,711	115%
Cca Senior Care Options	$2,766	117%
Cigna	$2,793	118%
Centivo	$5,533	235%
Claimdoc	$5,810	246%
Diversified Administrators	$5,810	246%
Innovative Health Plan II	$5,810	246%
Bcn Domestic	$8,206	348%
Blue Benefit Administrators of Massachusetts	$8,206	348%
Blue Care Network	$8,206	348%
Blue Distinction Transplant	$8,206	348%
Blue Shield - Ca	$8,206	348%
Blue Shield - Id (Regence)	$8,206	348%
Blue Shield - Ny Highmark Northeastern	$8,206	348%
Blue Shield - Ny Highmark Western	$8,206	348%
Blue Shield - PA (Highmark)	$8,206	348%
Blue Shield - Wa (Regence)	$8,206	348%
Health Choices	$8,206	348%
Kaiser Domestic	$8,206	348%
Pre-Employment	$8,206	348%
Unicare	$8,206	348%
Wc Domestic	$8,206	348%
Wellpoint	$8,206	348%

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 $7,555.
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 Saint Mary's 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.