CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Pulaski Memorial Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $495
Cash Discount Price: $644
vs. Medicare Baseline: 0.21x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Pulaski Memorial Hospital is $495. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $644. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.21x the Medicare baseline. Located in 616 E 13Th St, Winamac, IN.

Cash / Self-Pay

$644

Average discount available for prompt cash payment at this facility.

Insurance Median

$495

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: $644 (27%)

Insurance Median: $495 (21%)

Cash: $644 (27% of Medicare)

Ins. Median: $495 (21% 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
Ambetter / Centene	$438	19%
Blue Cross Blue Shield	$438 - $954	19%
Caresource Mcaid Hip	$438	19%
Caresource Mcare Hmo	$438	19%
Cenpatico Mcaid Hip	$438	19%
Humana	$438 - $672	19%
Mhs Mcaid Hip	$438	19%
Mhs Mcare Allwell	$438	19%
Multiplan - All Plans	$438	19%
UnitedHealthcare	$438 - $521	19%
Caresource Mcaid Hhw	$492	21%
Cenpatico Mcaid Hhw - All Other Plans	$492	21%
Mhs Mcaid Hhw/Hcc	$492	21%
Mdwise Mcaid Hcc	$498	21%
Mdwise Mcaid Hhw	$498	21%
Mdwise Mcaid Hip - All Other Plans	$498	21%
Caresource Exch Hmo Hix - All Other Plans	$548	23%
Encore Ppo - All Other Plans	$592	25%
Encore Workers Comp	$828	35%
Cigna	$954	40%
Sagamore - All Other Plans	$954	40%
Sagamore Rose Acre	$954	40%
Community Health Alliance - All Plans	$1,065	45%

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 $644.
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 Pulaski Memorial 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.