CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Cleveland Clinic Martin North Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $726
Cash Discount Price: $2,055
vs. Medicare Baseline: 0.31x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Cleveland Clinic Martin North Hospital is $726. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,055. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.31x the Medicare baseline. Located in 200 Se Hospital Ave, Stuart, FL.

Cash / Self-Pay

$2,055

Average discount available for prompt cash payment at this facility.

Insurance Median

$726

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: $2,055 (87%)

Insurance Median: $726 (31%)

Cash: $2,055 (87% of Medicare)

Ins. Median: $726 (31% 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
Freedom Health	$412 - $2,404	17%
Amerihealth	$424	18%
Miami Childrens Health Plan	$432 - $2,289	18%
Molina	$432	18%
Sunshine Health	$432	18%
Independent Living Systems	$494 - $562	21%
Avmed	$535 - $8,814	23%
Blue Cross Blue Shield	$535 - $2,289	23%
United	$535 - $2,289	23%
Careplus	$562 - $2,404	24%
Cigna	$577 - $740	24%
Clear Spring Health	$578	25%
Aetna	$652 - $2,845	28%
Multiplan	$802	34%
Clarity Health	$2,055	87%
The Legacy Companies	$2,055	87%
Humana	$2,289	97%
Wellcare	$2,289	97%
Consociate Health	$2,371	101%
Devoted Health	$2,518	107%

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 $2,055.
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 Cleveland Clinic Martin North 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.