CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Ochsner St Mary

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $2,075
Cash Discount Price: $4,328
vs. Medicare Baseline: 0.88x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Ochsner St Mary is $2,075. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,328. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.88x the Medicare baseline. Located in 1125 Marguerite Street, Morgan City, LA.

Cash / Self-Pay

$4,328

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,075

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: $4,328 (184%)

Insurance Median: $2,075 (88%)

Cash: $4,328 (184% of Medicare)

Ins. Median: $2,075 (88% 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
Tricare	$879 - $2,223	37%
Healthy Blue (Healthy Louisiana)	$888	38%
Humana	$888 - $2,075	38%
Louisiana Healthcare Connections (Healthy Louisiana)	$888	38%
UnitedHealthcare	$888 - $4,043	38%
Aetna	$915 - $2,075	39%
Amerihealth Caritas Louisiana (Healthy Louisiana)	$915	39%
American Health Advantage Of Louisiana (Formerly Dignity Health Plan)	$2,075	88%
Blue Cross Blue Shield	$2,075 - $2,981	88%
Healthy Blue Dual Advantage (Hmo-D-Snp)	$2,075	88%
Medicare (plans)	$2,075	88%
Ochsner Health Plan	$2,075	88%
Zelis	$3,125	133%
Claritev D/B/A Multiplan/Phcs/American Life Care	$3,304	140%

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 $4,328.
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 Ochsner St Mary 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.