CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Westchester Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $8,109
Cash Discount Price: $6,281
vs. Medicare Baseline: 3.44x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Westchester Medical Center is $8,109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,281. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 3.44x the Medicare baseline. Located in 100 Woods Rd, Valhalla, NY.

Cash / Self-Pay

$6,281

Average discount available for prompt cash payment at this facility.

Insurance Median

$8,109

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: $6,281 (266%)

Insurance Median: $8,109 (344%)

Cash: $6,281 (266% of Medicare)

Ins. Median: $8,109 (344% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 344% of the Medicare baseline (a markup of 244%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$4,529 - $6,039	192%
UnitedHealthcare	$5,826 - $8,109	247%
Oxford	$6,169 - $8,109	262%
Cigna	$6,379	271%
Cdphp	$8,355 - $10,997	354%
Emblem	$8,800	373%
Aetna	$10,044 - $12,990	426%
Mvp	$12,983 - $16,061	551%

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 $6,281.
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 Westchester Medical Center 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.