CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Kaleida Health

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $3,082
Cash Discount Price: $1,650
vs. Medicare Baseline: 1.31x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Kaleida Health is $3,082. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,650. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.31x the Medicare baseline. Located in 100 High Street, Buffalo, NY.

Cash / Self-Pay

$1,650

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,082

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: $1,650 (70%)

Insurance Median: $3,082 (131%)

Cash: $1,650 (70% of Medicare)

Ins. Median: $3,082 (131% 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
Ghi/Emblem Health	$604 - $3,889	26%
Ghi/Emblem Health - Wchob	$604 - $755	26%
Aetna	$629 - $5,157	27%
Magnacare	$629 - $3,420	27%
Magnacare - Wchob	$629 - $3,420	27%
Univera	$1,127 - $4,015	48%
Univera - Wchob	$1,127 - $3,904	48%
Independent Health Association	$1,676 - $4,559	71%
Independent Health Association - Wchob	$1,739 - $4,671	74%
Blue Cross Blue Shield	$1,964 - $10,750	83%
Tricare	$2,737	116%
Wellcare	$2,996	127%
Fidelis	$3,111	132%
UnitedHealthcare	$3,126	133%
Cigna	$3,371 - $4,091	143%

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 $1,650.
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 Kaleida Health 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.