CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Astera Health

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $5,241
Cash Discount Price: $7,523
vs. Medicare Baseline: 2.22x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Astera Health is $5,241. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,523. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 2.22x the Medicare baseline. Located in 421 11Th Street Nw, Wadena, MN.

Cash / Self-Pay

$7,523

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,241

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: $7,523 (319%)

Insurance Median: $5,241 (222%)

Cash: $7,523 (319% of Medicare)

Ins. Median: $5,241 (222% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 222% of the Medicare baseline (a markup of 122%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Plus Pmap [40002]	$399 - $516	17%
Blue Cross Blue Shield	$516 - $7,924	22%
Health Partners [10045]	$516 - $7,450	22%
Medica Nonpmap [10056]	$516 - $8,117	22%
Primewest Non Pmap [30004]	$516	22%
Ucare Pmap [30006]	$3,793	161%
Medica Pmap [10057]	$4,168	177%
Primewest Pmap [30003]	$4,168	177%
Ucare Non Pmap [30007]	$4,376	186%
Health Partners Pmap [10046]	$5,241	222%
Ucare Commercial [10705]	$7,746	329%
UnitedHealthcare	$8,054	342%
Multiplan	$8,336	354%
Sanford Health Plan [10120]	$8,857	376%
Aetna	$9,378	398%

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 $7,523.
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 Astera Health 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.