CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Centrastate Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $2,646
Cash Discount Price: $3,043
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Centrastate Medical Center is $2,646. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,043. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.12x the Medicare baseline. Located in 901 West Main Street, Freehold, NJ.

Cash / Self-Pay

$3,043

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,646

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: $3,043 (129%)

Insurance Median: $2,646 (112%)

Cash: $3,043 (129% of Medicare)

Ins. Median: $2,646 (112% 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
Wtc Health Program [5273]	$1,062	45%
Horizon Nj Health [5021]	$2,146	91%
Fairos [5491]	$2,524	107%
Us Marshall Service [5429]	$2,524	107%
Aetna	$2,646 - $3,705	112%
Ambetter / Centene	$2,646	112%
Amerihealth Administrators Supplemental [5512]	$2,646	112%
Amerihealth Medigap [5049]	$2,646	112%
Blue Cross Blue Shield	$2,646	112%
Champva [5354]	$2,646	112%
Cigna	$2,646	112%
Claim Watcher/Homestead [5488]	$2,646	112%
Claimdoc [5434]	$2,646	112%
Compassionate Care [5442]	$2,646	112%
Cosmetic Surgery/Lap Band/Gastric Bypass [5289]	$2,646	112%
Cs Card Rehab Cash Pay [5497]	$2,646	112%
Cs Nutrition Consult-Initial and Follow Up [5493]	$2,646	112%
Cs Pulmonary Rehab Cash Pay [5496]	$2,646	112%
Cs Radiology Cash Pay [5498]	$2,646	112%
Cs Rehab Cash Pay [5495]	$2,646	112%
Cs Sports Performance Eval and Visits [5494]	$2,646	112%
Highmark Wholecare Health Plan Ip Splits [5464]	$2,646	112%
Highmark Wholecare Health Plan [5413]	$2,646	112%
Medicaid / KanCare	$2,646	112%
Medicare (plans)	$2,646 - $2,739	112%
Sedgwick Wtc Health Program Wc [5514]	$2,646	112%
Specialty Imaging [5433]	$2,646	112%
Tricare	$2,646	112%
UPMC [5455]	$2,646	112%
Us Family Health Plan [5258]	$2,646	112%
VA Community Care Network [5403]	$2,646	112%
Wellcare Behavioral Health [5335]	$2,646	112%
Wellcare Health Plans Ip Splits [5475]	$2,646	112%
Wellcare Health Plans [5269]	$2,646	112%
Amerihealth Caritas Vip Care Ip Splits [5460]	$2,673	113%
Amerihealth Caritas Vip Care [5313]	$2,673	113%
Amerihealth [5008]	$10,426	442%
Kessler Foundation [5532]	$12,000	509%

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 $3,043.
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 Centrastate 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.