CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Northwest Health - Porter

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 66984
  • Insurance Median: $4,316
  • Cash Discount Price: $4,830
  • vs. Medicare Baseline: 1.83x Medicare
The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Northwest Health - Porter is $4,316. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,830. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.83x the Medicare baseline. Located in 85 East Us Hwy 6, Valparaiso, IN.
Cash / Self-Pay
$4,830

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,316

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: $4,830 (205%)
Insurance Median: $4,316 (183%)
Cash: $4,830 (205% of Medicare)
Ins. Median: $4,316 (183% 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.

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
One Call $438 19%
Veterans Eval Services $492 21%
Aetna $1,173 - $8,640 50%
UnitedHealthcare $2,162 - $4,316 92%
Tricare $2,320 98%
Blue Cross Blue Shield $2,403 - $9,951 102%
Humana $2,403 - $4,316 102%
Medicare (plans) $2,403 - $2,564 102%
Node Mhs Mcr Adv $2,403 102%
Healthy Indiana Plan $2,442 104%
Node Hospice Non Par Agree $2,442 104%
Node Va $2,442 104%
Node Devoted Health Mcr Adv $2,450 104%
Care Improvement Plus $2,523 107%
In Dept Of Correction $2,539 108%
Node Us Dept Of Labor $3,052 129%
Align Network $3,907 166%
One Call Work Comp $3,907 166%
Lutheran Preferred Chs Employees $4,293 182%
Caresource $4,316 183%
Managed Health Services $4,316 - $4,883 183%
Medicaid / KanCare $4,316 183%
Mhs $4,316 183%
Encore Health $4,395 - $14,311 186%
Prime Health $4,395 - $13,416 186%
Self Pay $4,830 205%
Indiana Work Comp $4,883 207%
Lutheran Preferred $4,883 - $10,733 207%
Cigna $4,973 211%
Node Encore Kba Epo $5,860 249%
Porter County $5,860 249%
Preferred Network Access $5,860 249%
Magnacare Ma $6,219 264%
Physicians Health Plan $6,855 291%
Php Freedom $7,390 313%
Sagamore Health Network $7,907 - $10,590 335%
First Health Coventry $8,765 372%
Encore Ppo $8,944 379%
Southeastem Indiana Health Operations $12,522 - $13,416 531%
Network Synergy Group $13,416 569%
Multiplan/Phcs $15,026 637%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 85 East Us Hwy 6, Valparaiso, IN 46383
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals