CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Albany Medical Center Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $566
Cash Discount Price: $1,281
vs. Medicare Baseline: 0.24x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Albany Medical Center Hospital is $566. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,281. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.24x the Medicare baseline. Located in 43 New Scotland Avenue, Mail Code 34, Albany, NY.

Cash / Self-Pay

$1,281

Average discount available for prompt cash payment at this facility.

Insurance Median

$566

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: $1,281 (54%)

Insurance Median: $566 (24%)

Cash: $1,281 (54% of Medicare)

Ins. Median: $566 (24% 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
Magnacare	$52	2%
Cdphp	$342 - $5,458	15%
Medicare (plans)	$378 - $566	16%
Fidelis	$396 - $5,458	17%
Blue Cross Blue Shield	$415 - $5,458	18%
Tricare	$428 - $503	18%
Medicaid / KanCare	$444 - $474	19%
Hamaspik	$471 - $5,700	20%
Mvp	$484 - $2,564	21%
Blue Shield Highmark	$500 - $1,082	21%
UnitedHealthcare	$503 - $1,420	21%
Aetna	$524 - $2,834	22%
Nascentia	$554	23%
Emblem Health Ghi	$559 - $1,092	24%
Cigna	$756 - $915	32%
Nys Department Of Corrections	$1,398	59%
Blue Shield	$2,573	109%
Mvp Essential Plan	$5,215	221%

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 $1,281.
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 Albany Medical Center 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.