CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Montefiore New Rochelle Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $2,699
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.14x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Montefiore New Rochelle Hospital is $2,699. 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 1.14x the Medicare baseline. Located in 16 Guion Place, New Rochelle, NY.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,699

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: $2,699 (114%)

Ins. Median: $2,699 (114% 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	$548 - $11,793	23%
Healthfirst	$1,785 - $2,699	76%
Molina Healthcare Of Ny Affinity	$2,293 - $5,171	97%
Amidacare	$2,340 - $2,834	99%
Emblem	$2,340 - $15,963	99%
Empire	$2,340 - $9,074	99%
Fidelis	$2,340 - $2,808	99%
Medicaid / KanCare	$2,340	99%
Metroplus	$2,340 - $4,212	99%
Mvp	$2,340 - $4,797	99%
Wellcare	$2,363 - $2,753	100%
Hamaspik	$2,457 - $2,915	104%
Vnsny Choice	$2,691 - $2,699	114%
Vnsny Select Health	$2,691	114%
Villagecaremax	$2,699	114%
Centerlight	$2,780	118%
Partners_Health_Plan	$2,834	120%
Humana	$2,969	126%
Oscar	$3,549 - $7,276	151%
Aetna	$6,200 - $6,935	263%
Northwell	$7,259	308%

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 New Rochelle 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.