CMS Price Transparency Data

Cataract surgery with lens implant

Facility: St Lukes Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $860
Cash Discount Price: $3,869
vs. Medicare Baseline: 0.36x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at St Lukes Hospital is $860. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,869. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.36x the Medicare baseline. Located in 915 East 1St Street, Duluth, MN.

Cash / Self-Pay

$3,869

Average discount available for prompt cash payment at this facility.

Insurance Median

$860

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: $3,869 (164%)

Insurance Median: $860 (36%)

Cash: $3,869 (164% of Medicare)

Ins. Median: $860 (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
Medica	$214 - $1,754	9%
Security Health Plan Of Wisconsin, Inc.	$253 - $9,443	11%
Blue Cross Blue Shield	$375 - $7,557	16%
Ucare	$390 - $425	17%
UnitedHealthcare	$419 - $774	18%
Humana	$431 - $2,509	18%
Aetna	$506 - $2,461	21%
Healthpartners	$515 - $2,437	22%
Tricare	$516	22%
Group Health Cooperative Of Eau Claire	$729	31%
America'S Ppo	$5,907	251%

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 $3,869.
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 St Lukes 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.