CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Jersey Shore University Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $5,328
Cash Discount Price: $2,524
vs. Medicare Baseline: 2.26x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Jersey Shore University Medical Center is $5,328. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,524. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 2.26x the Medicare baseline. Located in 1945 Rte 33, Neptune, NJ.

Cash / Self-Pay

$2,524

Average discount available for prompt cash payment at this facility.

Insurance Median

$5,328

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: $2,524 (107%)

Insurance Median: $5,328 (226%)

Cash: $2,524 (107% of Medicare)

Ins. Median: $5,328 (226% 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 226% of the Medicare baseline (a markup of 126%). 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	$1,110 - $10,202	47%
Karna	$1,119	47%
UnitedHealthcare	$1,189 - $10,276	50%
Clover	$1,204	51%
Seoul Medical Group	$1,545	66%
Blue Cross Blue Shield	$2,524	107%
Vaccn	$2,524	107%
Wellcare	$2,524	107%
United Community/Americhoice	$2,651	112%
Horizon	$3,153 - $14,615	134%
Beacon	$5,016	213%
Bergen Risk	$5,016	213%
Qualcare	$5,197 - $6,256	220%
Cigna	$5,350 - $7,456	227%
Activecare First McO	$5,685	241%
Multiplan - PHCS	$5,685	241%
Amerihealth	$5,843 - $6,617	248%
Oxford	$8,522	361%
Brighton Health Plan	$10,163	431%

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 $2,524.
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 Jersey Shore University 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.