CMS Price Transparency Data

Cataract surgery with lens implant

Facility: St Charles 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 St Charles 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 200 Belle Terre Road, Port Jefferson, 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.

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
Zadroga $1,095 46%
Brighton $1,800 - $5,269 76%
Affinity Health Plan $2,456 - $5,525 104%
Beacon Health Options $2,456 - $3,778 104%
Beacon Health Strategies $2,456 - $3,778 104%
Centerlight Healthcare $2,456 - $2,699 104%
Elderplan Inc. $2,456 - $2,699 104%
Emblem Health $2,456 - $4,845 104%
Fidelis Care New York $2,456 - $5,525 104%
Health First $2,456 - $6,073 104%
Health Plus $2,456 - $5,525 104%
Independent Health $2,456 - $2,699 104%
Medicaid / KanCare $2,456 104%
Mvp Health Plans $2,456 - $5,566 104%
Senior Whole Health $2,456 - $2,699 104%
UnitedHealthcare $2,456 - $5,525 104%
Blue Cross Blue Shield $2,645 - $3,649 112%
Aetna $2,699 - $5,069 114%
Centers Plan For Healthy Living $2,699 114%
Healthspring $2,699 114%
Liberty Health $2,699 114%
Longevity Health Plan $2,699 114%
Medicare (plans) $2,699 - $2,834 114%
Orthonet - Uniformed Services Family Health Plan $2,699 114%
Pmc $2,699 114%
Tricare $2,699 114%
Universal Healthcare $2,699 114%
Us Family Health Plan $2,699 114%
Veterans Affairs $2,699 114%
Humana $2,753 117%
Agewell New York $2,793 118%
Partners Health Plan $2,834 120%
Wellcare Health Plan Inc $2,969 126%
Centivo $3,398 - $5,566 144%
Self Pay $3,649 155%
Local 1199 $3,945 167%
Surest $4,311 183%
American Plan Administrators $4,845 205%
Amerihealth Administrators $4,845 205%
Benefit Services $4,845 205%
Ghi Cbp Ny City Employee Alternate $4,845 205%
International Benefit Administrator $4,845 205%
Ultra Benefits Inc. $4,845 205%
Mail Handlers Benefit Plan $5,069 215%
Meritain Health $5,069 215%
Nippon Life Insurance Company Of America $5,069 215%
Salvation Army $5,069 215%
Apwu $5,566 236%
Cigna $5,566 236%
Daniel H Cook $5,566 236%
Nalc $5,566 236%
Samba $5,566 236%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Belle Terre Road, Port Jefferson, NY 11777
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals