CMS Price Transparency Data

Cataract surgery with lens implant

Facility: UNM Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $2,137
Cash Discount Price: $3,006
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at UNM Hospital is $2,137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,006. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.91x the Medicare baseline. Located in 2211 Lomas Boulevard Ne, Albuquerque, NM.

Cash / Self-Pay

$3,006

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,137

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: $3,006 (127%)

Insurance Median: $2,137 (91%)

Cash: $3,006 (127% of Medicare)

Ins. Median: $2,137 (91% 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
Blue Cross Blue Shield	$582 - $2,273	25%
Humana	$818 - $2,046	35%
Aetna	$909 - $2,273	39%
Alamo Navajo School Board	$909 - $2,273	39%
Indian Health Abq	$909 - $2,273	39%
Kewa Pueblo Health Corporation	$909 - $2,273	39%
Pueblo Of Isleta	$909 - $2,273	39%
Pueblo Of Jemez	$909 - $2,273	39%
Pueblo Of Sandia	$909 - $2,273	39%
UnitedHealthcare	$909 - $2,273	39%
Devoted Health	$1,091 - $2,728	46%
Christus	$1,364 - $3,410	58%
Albuquerque Public Schools	$1,819 - $4,547	77%
Presbyterian Network	$1,819 - $4,547	77%
Christus Health Exchange Plan	$2,046 - $5,115	87%
Imperial Health Exchange	$2,228 - $5,570	94%
Molina	$2,228 - $5,570	94%

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 $3,006.
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 UNM Hospital 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.