CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Boston Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $2,350
Cash Discount Price: $1,322
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Boston Medical Center is $2,350. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,322. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.00x the Medicare baseline. Located in 1 Boston Medical Center Place, Boston, MA.

Cash / Self-Pay

$1,322

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,350

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: $1,322 (56%)

Insurance Median: $2,350 (100%)

Cash: $1,322 (56% of Medicare)

Ins. Median: $2,350 (100% 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
Tufts Conncare/Qhp [8020]	$431 - $3,809	18%
Hsn Bad Debt [4003]	$513	22%
Hsn Confidential [4007]	$513	22%
Hsn Dental [4006]	$513	22%
Hsn Partial [4002]	$513	22%
Hsn [4001]	$513	22%
UnitedHealthcare	$695 - $6,586	29%
Medicaid / KanCare	$1,057	45%
Uphams Corner Esp [1213]	$1,175	50%
Workers Comp [5002]	$1,259	53%
Zzzbu Employee Work Comp [5004]	$1,259	53%
Zzzcity Of Boston Work Comp [5003]	$1,259	53%
Aetna	$1,436	61%
Meritain Health [1023]	$1,436	61%
Mass General Brigham Health Plan Commercial [8009]	$1,584	67%
Harvard Pilgrim Health Care [8001]	$1,725	73%
Health Plans Inc [2027]	$1,725	73%
United [2025]	$1,725 - $6,586	73%
Zzzhealth Plans Inc [1013]	$1,725	73%
Zzzunited [1008]	$1,725 - $6,586	73%
Tufts [8002]	$1,755 - $3,588	74%
Blue Cross Blue Shield	$2,192	93%
Unicare [8004]	$2,203	93%
Wellpoint [2034]	$2,203	93%
Cigna	$2,496 - $3,588	106%
Medicare (plans)	$2,681 - $2,815	114%
Ubh Hphc [8016]	$2,681	114%
Zzzcovid19 Hrsa Uninsured Testing And Treatment Fund [500010]	$2,681	114%
Wellcare [1240]	$2,788	118%
Cca [1215]	$2,815	119%
Corrections [9001]	$2,815 - $3,351	119%
Zzzcca Onecare [1216]	$2,815	119%
Eternalhealth [1227]	$2,842	121%
Fallon Sco [1126]	$2,949	125%
Senior Whole Health [1210]	$3,217	136%
Fallon [8008]	$3,485	148%
Oxford Health [1007]	$6,586	279%
Oxford Health [2024]	$6,586	279%

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 $1,322.
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 Boston Medical Center 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.