CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Columbia Memorial Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $596
Cash Discount Price: $745
vs. Medicare Baseline: 0.25x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Columbia Memorial Hospital is $596. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $745. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.25x the Medicare baseline. Located in 71 Prospect Avenue, Hudson, NY.

Cash / Self-Pay

$745

Average discount available for prompt cash payment at this facility.

Insurance Median

$596

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: $745 (32%)

Insurance Median: $596 (25%)

Cash: $745 (32% of Medicare)

Ins. Median: $596 (25% 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
UnitedHealthcare	$226 - $679	10%
Mvp	$396 - $5,094	17%
Cdphp	$401 - $8,835	17%
Medicare (plans)	$424 - $566	18%
Medicaid / KanCare	$444 - $2,426	19%
Blue Cross Blue Shield	$481 - $4,488	20%
Tricare	$481 - $566	20%
Hamaspik	$529 - $3,671	22%
Fidelis	$537 - $5,458	23%
Aetna	$583 - $6,890	25%
Blue Shield Highmark	$596 - $675	25%
Cigna	$716 - $739	30%
Emblem Health Ghi	$775	33%
Empire Plan Nyship	$3,333	141%
Blue Shield	$3,923 - $7,552	166%
Herrington Diversified Pdh	$4,048	172%

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 $745.
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 Columbia Memorial 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.