CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Jfk University Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $4,682
Cash Discount Price: $2,404
vs. Medicare Baseline: 1.99x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Jfk University Medical Center is $4,682. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,404. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.99x the Medicare baseline. Located in 65 James Street, Edison, NJ.

Cash / Self-Pay

$2,404

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,682

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: $2,404 (102%)

Insurance Median: $4,682 (199%)

Cash: $2,404 (102% of Medicare)

Ins. Median: $4,682 (199% 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
Horizon	$1,026 - $8,615	44%
Aetna	$1,077 - $10,692	46%
UnitedHealthcare	$1,150 - $11,287	49%
Karna	$1,164	49%
Clover	$1,204	51%
Seoul Medical Group	$1,438	61%
Amerigroup	$2,281 - $2,527	97%
Vaccn	$2,281 - $2,527	97%
Wellcare	$2,281 - $2,527	97%
United Community/Americhoice	$2,395 - $2,653	102%
Blue Cross Blue Shield	$2,527	107%
Activecare First McO	$4,682	199%
Intergroup	$4,682	199%
Bergen Risk	$5,016	213%
Prime Health	$5,350	227%
Multiplan - PHCS	$5,685	241%
Cigna	$6,052	257%
Qualcare	$6,193	263%
Amerihealth	$6,327	268%
Oxford	$9,050	384%
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 $2,404.
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 Jfk 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.