CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Montefiore Mount Vernon Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $2,881
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.22x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Montefiore Mount Vernon Hospital is $2,881. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.22x the Medicare baseline. Located in 12 North 7Th Avenue, Mount Vernon, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,881

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%)

Insurance Median: $2,881 (122%)

Ins. Median: $2,881 (122% 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
American Postal Workers	$548 - $14,184	23%
UnitedHealthcare	$548 - $14,184	23%
Metroplus	$595 - $3,952	25%
Healthfirst	$1,785 - $3,579	76%
Amidacare	$2,196	93%
Blue Cross Blue Shield	$2,196 - $10,052	93%
Emblem	$2,196 - $18,107	93%
Fidelis	$2,196 - $3,842	93%
Medicaid / KanCare	$2,196	93%
Molina Healthcare of Ny Affinity	$2,196 - $4,940	93%
Mvp	$2,196 - $5,223	93%
Wellcare	$2,218 - $2,938	94%
Hamaspik	$2,305 - $2,371	98%
Vnsny Choice	$2,525 - $2,881	107%
Vnsny Select Health	$2,525	107%
Point Comfort	$2,881	122%
Villagecaremax	$2,881	122%
Centerlight	$2,967 - $3,169	126%
Elderplan	$2,967	126%
Partners Health Plan	$3,025	128%
Longevity	$3,140	133%
Humana	$3,169	134%
Oscar	$3,549 - $7,276	151%
Aetna	$5,250 - $5,873	223%
Northwell	$7,749	329%

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 $X.
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 Montefiore Mount Vernon 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.