CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Samaritan Hospital of Troy, New York

Billing Code: 66984 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$937

about 0.4× the $2,358 Medicare rate · typically $554–$3,012

modeled estimate · not a bill or quote

What this hospital charges insurers

$9,706

Well above the fair price

about $8,769 over the fair price · 4.1× Medicare

Medicare pays $2,358 Fair price $937 This hospital $9,706 Cash price $5,243

How we calculate the fair BaseRate →

How this hospital compares to other NY hospitals

Highest price of the 9 NY hospitals we have prices for — worth calling around.

Cheapest $554 Priciest $9,706

Black dot = this hospital, among the 9 NY hospitals with a price for this procedure. Full list below.

A fair price for a Cataract surgery with lens implant is about $937 (about 0.4× the $2,358 Medicare rate). Samaritan Hospital of Troy, New York charges insurers about $9,706, or about $5,243 in cash — well above the fair price. Located in Troy, NY.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $937. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$1,555 - $12,754	66%
Blue Cross Blue Shieldmajor	$2,823 - $30,267	120%
Aetnamajor	$3,049 - $14,175	129%
Cignamajor	$9,012 - $18,024	382%
Fidelis Care	$5,185	220%
GEHA	$7,088 - $14,175	301%
Harvard Pilgrim	$6,377 - $12,754	270%
HealthPartners	$9,012 - $18,024	382%
Medical Mutual	$7,088 - $14,175	301%
MVP Health Care	$6,094 - $14,781	258%
Priority Health	$9,012 - $18,024	382%
Tufts Health Plan	$9,012 - $18,024	382%
UniCare	$6,629	281%
+ 18 smaller / regional plans	$359 - $20,043

Government programs also on file: Medicare, Medicaid.

Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 5,243), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 66984.

Insurance Before you use insurance

Call your insurance company to confirm Samaritan Hospital of Troy, New York is in-network.
Ask your insurer whether prior approval is required for CPT code 66984.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Samaritan Hospital of Troy, New York

Compare: Cataract surgery with lens implant at other NY hospitals

Insurance negotiated median for the same procedure, sorted lowest first.