CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Saint Anthony Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $3,313
Cash Discount Price: $2,043
vs. Medicare Baseline: 1.41x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Saint Anthony Hospital is $3,313. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,043. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.41x the Medicare baseline. Located in 2875 West 19Th Street, Chicago, IL.

Cash / Self-Pay

$2,043

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,313

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: $2,043 (87%)

Insurance Median: $3,313 (141%)

Cash: $2,043 (87% of Medicare)

Ins. Median: $3,313 (141% 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
Access Community Health Network	$2,102 - $2,584	89%
UnitedHealthcare	$2,215 - $2,437	94%
Aetna	$2,377 - $5,617	101%
Blue Cross Blue Shield	$2,377 - $3,490	101%
Cigna	$2,377 - $4,564	101%
Humana	$2,377	101%
Oak Street Health	$2,377	101%
Zing Health	$2,377	101%
Healthlink	$3,204	136%
Healthsmart	$4,541 - $5,242	193%
Galaxy Health Network	$5,190 - $5,991	220%
Prime Health	$5,190 - $5,991	220%
Zelis Healthcare	$5,190 - $5,991	220%

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 $2,043.
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 Anthony 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.