CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Dukes Memorial Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $834
Cash Discount Price: $973
vs. Medicare Baseline: 0.35x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Dukes Memorial Hospital is $834. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $973. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.35x the Medicare baseline. Located in 275 W 12Th St, Peru, IN.

Cash / Self-Pay

$973

Average discount available for prompt cash payment at this facility.

Insurance Median

$834

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: $973 (41%)

Insurance Median: $834 (35%)

Cash: $973 (41% of Medicare)

Ins. Median: $834 (35% 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
Department Of Veterans Affairs	$343	15%
Tricare	$343	15%
Blue Cross Blue Shield	$365 - $10,034	15%
Humana	$365	15%
Iu Health Plan	$365	15%
Managed Health Services	$365 - $742	15%
Medicare (plans)	$365	15%
UnitedHealthcare	$365 - $912	15%
Node Va	$371 - $895	16%
Aetna	$372 - $882	16%
Node Devoted Health Mcr Adv	$372	16%
In Dept Of Correction	$386	16%
Miami County Sheriffs Department	$386	16%
Node Pphp Mcr Adv	$389	16%
One Call Wc	$438	19%
Veterans Eval Services	$492	21%
Lutheran Advanced Network	$556	24%
Lutheran Three Rivers Preferred Plus 150	$556	24%
Node Lutheran Preferred Fixed 2	$556	24%
Lutheran Preferred	$590 - $1,483	25%
Align Network	$593	25%
Lutheran Three Rivers Preferred Plus 175	$649	28%
Encore Work Comp In	$667	28%
Prime Health Services	$667 - $1,390	28%
Partners Direct Health Llc	$705	30%
Lutheran Northwest Health Preferred	$742	31%
Three Rivers Preferred Plus	$742	31%
Work Comp	$742	31%
Physicians Health Plan	$746 - $864	32%
Cigna	$786 - $1,854	33%
Three Rivers Preferred	$834	35%
Php Freedom	$856	36%
Encore Kba Epo	$890	38%
Amish Aid	$927	39%
Encore Ppo	$927	39%
Self Pay	$927 - $1,020	39%
Us Department Of Labor	$981	42%
Sagamore Health Network	$1,027	44%
Encore Kba Ppo	$1,112	47%
Consumer Life	$1,149	49%
First Health	$1,483	63%
Multiplan	$1,502	64%
Encore Health Network	$1,520	64%
Advantage Health Solutions	$1,539	65%
Encore	$1,669	71%

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 $973.
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 Dukes 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.