CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Catawba Valley Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $5,760
Cash Discount Price: $8,087
vs. Medicare Baseline: 2.44x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Catawba Valley Medical Center is $5,760. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,087. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 2.44x the Medicare baseline. Located in 810 Fairgrove Church Rd, Hickory, NC.

Cash / Self-Pay

$8,087

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,760

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: $8,087 (343%)

Insurance Median: $5,760 (244%)

Cash: $8,087 (343% of Medicare)

Ins. Median: $5,760 (244% 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 244% of the Medicare baseline (a markup of 144%). 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
UnitedHealthcare	$1,134 - $6,740	48%
Cigna	$2,160 - $7,413	92%
Humana	$2,203 - $10,783	93%
Wellcare	$2,225	94%
Blue Cross Blue Shield	$2,268 - $6,659	96%
Devoted Health	$2,268	96%
Gateway	$2,268	96%
Longevity Healthcare	$2,268	96%
Liberty Advantage	$2,289	97%
Troy	$2,289	97%
Caresource North Carolina	$4,860	206%
Medcost	$6,740 - $9,233	286%
Directnet	$8,087	343%
Aetna	$8,209	348%
Prime Health Service	$10,109	429%
Multiplan	$11,457	486%

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 $8,087.
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 Catawba Valley 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.