CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Sparrow Ionia Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $2,417
Cash Discount Price: $825
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Sparrow Ionia Hospital is $2,417. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $825. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.03x the Medicare baseline. Located in 3565 S State Road, Ionia, MI.

Cash / Self-Pay

$825

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,417

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: $825 (35%)

Insurance Median: $2,417 (103%)

Cash: $825 (35% of Medicare)

Ins. Median: $2,417 (103% 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
Medicaid / KanCare	$344 - $2,594	15%
Medicare (plans)	$501 - $1,181	21%
Blue Cross Blue Shield	$859 - $2,793	36%
Aetna	$1,114 - $3,340	47%
Covenant Advantage	$1,114	47%
Medigold	$1,114	47%
Senior Community Care	$1,114	47%
Humana	$1,169 - $3,608	50%
Priority Health Medihmo	$2,358	100%
Priority	$2,733	116%
UnitedHealthcare	$3,416	145%
Cigna	$3,528	150%
Great West Healthcare	$3,528	150%
Asr	$3,563	151%
Blue Care Network	$3,563	151%
Health Alliance Plan	$3,563	151%
Cofinity	$3,608	153%
Mclaren Commercial	$3,969	168%

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 $825.
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 Sparrow Ionia 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.