CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Carle Eureka Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $1,230
Cash Discount Price: $2,734
vs. Medicare Baseline: 0.52x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Carle Eureka Hospital is $1,230. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,734. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.52x the Medicare baseline. Located in 101 S Major St, Eureka, IL.

Cash / Self-Pay

$2,734

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,230

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: $2,734 (116%)

Insurance Median: $1,230 (52%)

Cash: $2,734 (116% of Medicare)

Ins. Median: $1,230 (52% 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
Cigna	$82	3%
Meridian	$273 - $1,312	12%
Humana	$539 - $1,230	23%
Molina	$547 - $1,312	23%
Aetna	$555 - $1,807	24%
UnitedHealthcare	$1,230 - $1,687	52%
Community Partners Health Plan (Cphp)	$1,640	70%
Healthlink	$1,777	75%
Blue Cross Blue Shield	$1,832 - $2,297	78%
Multiplan/Phcs	$2,050	87%
Wellcare	$2,473	105%

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 $2,734.
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 Carle Eureka 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.