CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Saratoga Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $544
Cash Discount Price: $1,575
vs. Medicare Baseline: 0.23x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Saratoga Hospital is $544. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,575. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.23x the Medicare baseline. Located in 211 Church Street, Saratoga Springs, NY.

Cash / Self-Pay

$1,575

Average discount available for prompt cash payment at this facility.

Insurance Median

$544

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: $1,575 (67%)

Insurance Median: $544 (23%)

Cash: $1,575 (67% of Medicare)

Ins. Median: $544 (23% 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
Cdphp	$342 - $5,464	15%
Fidelis	$378 - $5,464	16%
Medicare (plans)	$378 - $503	16%
Blue Cross Blue Shield	$415 - $5,463	18%
Tricare	$428 - $503	18%
Medicaid / KanCare	$444 - $474	19%
Hamaspik	$471 - $5,707	20%
Mvp	$484 - $915	21%
Emblem Health Ghi	$503 - $554	21%
UnitedHealthcare	$503 - $2,428	21%
Aetna	$513 - $627	22%
Blue Shield Highmark	$588 - $696	25%
Cigna	$756 - $915	32%
Mvp Essential Plan	$2,428 - $4,857	103%
Mvp Govt Programs	$2,428	103%
Emblem	$2,699	114%
Empire Plan Nyship	$5,463	232%

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 $1,575.
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 Saratoga 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.