CMS Price Transparency Data

Cataract surgery with lens implant

Facility: St Lucie Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $4,596
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.95x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at St Lucie Medical Center is $4,596. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.95x the Medicare baseline. Located in 1800 Se Tiffany Ave, Port Saint Lucie, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,596

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%)

Insurance Median: $4,596 (195%)

Ins. Median: $4,596 (195% 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	$1,495 - $2,350	63%
Molina	$1,950 - $2,702	83%
Health Sun Health Plan	$2,050	87%
Simply Healthcare Plans	$2,160	92%
Optimum	$2,350	100%
Corvel Corporation	$4,204 - $4,501	178%
Avmed	$4,281	182%
Careworks (Rockport)	$4,292 - $4,596	182%
Prime Health	$4,292 - $4,596	182%
Simply Healthcare	$9,488	402%
Oscar	$10,148	430%
Blue Cross Blue Shield	$10,230 - $15,120	434%
Cigna	$11,166 - $15,153	474%
United	$31,400	1332%

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 $X.
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 St Lucie 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.