CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Covenant Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $859
Cash Discount Price: $750
vs. Medicare Baseline: 0.36x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Covenant Medical Center is $859. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $750. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.36x the Medicare baseline. Located in 1447 N Harrison, Saginaw, MI.

Cash / Self-Pay

$750

Average discount available for prompt cash payment at this facility.

Insurance Median

$859

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: $750 (32%)

Insurance Median: $859 (36%)

Cash: $750 (32% of Medicare)

Ins. Median: $859 (36% 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
Aetna	$447 - $2,358	19%
Blue Cross Blue Shield	$447 - $3,802	19%
Health Alliance Plan Of Michigan	$447 - $4,551	19%
Healthy Michigan Mclaren	$447 - $1,233	19%
Healthy Michigan Meridian	$447 - $1,233	19%
Healthy Michigan Molina	$447 - $1,233	19%
Healthy Michigan Priority Health	$447 - $1,233	19%
Humana	$447 - $2,358	19%
Mclaren Advantage	$447 - $2,358	19%
Molina Healthplan	$447 - $2,358	19%
Physicians Health Plan Advantage/Advantage Plus	$447 - $2,358	19%
Priority Health	$447 - $2,358	19%
Health Advantage Mclaren Employee	$482 - $724	20%
Priority Health E	$493 - $740	21%
Physicians Health Plan	$590 - $885	25%
Mclaren Health Advantage	$738 - $1,107	31%
Meritain Health	$820 - $1,231	35%
Blue Care Network	$859 - $3,802	36%
Multiplan	$965 - $1,448	41%

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 $750.
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 Covenant 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.