CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Southern Ocean Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 66984
  • Insurance Median: $5,635
  • Cash Discount Price: $2,493
  • vs. Medicare Baseline: 2.39x Medicare
The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Southern Ocean Medical Center is $5,635. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,493. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 2.39x the Medicare baseline. Located in 1140 Rt 72 W, Manahawkin, NJ.
Cash / Self-Pay
$2,493

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,635

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: $2,493 (106%)
Insurance Median: $5,635 (239%)
Cash: $2,493 (106% of Medicare)
Ins. Median: $5,635 (239% 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 239% of the Medicare baseline (a markup of 139%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Karna $1,119 47%
UnitedHealthcare $1,189 - $10,216 50%
Clover $1,323 56%
Aetna $1,360 - $9,383 58%
Seoul Medical Group $1,507 64%
Blue Cross Blue Shield $2,493 106%
Vaccn $2,493 106%
Wellcare $2,493 106%
United Community/Americhoice $2,617 111%
Horizon $2,897 - $6,720 123%
Qualcare $4,632 - $6,675 196%
Bergen Risk $5,513 234%
Cigna $5,881 - $7,458 249%
Multiplan - PHCS $6,248 265%
Amerihealth $6,384 - $7,230 271%
Oxford $8,251 350%
Brighton Health Plan $9,933 421%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1140 Rt 72 W, Manahawkin, NJ 08050
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals