CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Ocean Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $5,350
Cash Discount Price: $2,387
vs. Medicare Baseline: 2.27x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Ocean Medical Center is $5,350. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,387. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 2.27x the Medicare baseline. Located in 425 Jack Martin Blvd, Brick, NJ.

Cash / Self-Pay

$2,387

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,350

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: $2,387 (101%)

Insurance Median: $5,350 (227%)

Cash: $2,387 (101% of Medicare)

Ins. Median: $5,350 (227% 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 227% of the Medicare baseline (a markup of 127%). 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
Aetna	$1,044 - $10,692	44%
Karna	$1,119 - $1,164	47%
UnitedHealthcare	$1,189 - $10,334	50%
Clover	$1,323	56%
Seoul Medical Group	$1,426 - $1,438	60%
Horizon	$1,967 - $10,671	83%
Amerigroup	$2,281	97%
Vaccn	$2,281 - $2,493	97%
Wellcare	$2,281 - $2,493	97%
United Community/Americhoice	$2,395 - $2,617	102%
Blue Cross Blue Shield	$2,493	106%
Activecare First McO	$4,682 - $6,248	199%
Intergroup	$4,682	199%
Bergen Risk	$5,016 - $5,513	213%
Prime Health	$5,350	227%
Multiplan - PHCS	$5,685 - $6,248	241%
Qualcare	$5,712 - $6,469	242%
Cigna	$6,052 - $7,459	257%
Amerihealth	$6,316 - $7,154	268%
Oxford	$8,183	347%
Brighton Health Plan	$9,933	421%

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 $2,387.
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 Ocean 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.