CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Montefiore St Luke's Cornwall

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $2,881
Cash Discount Price: $2,881
vs. Medicare Baseline: 1.22x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Montefiore St Luke's Cornwall is $2,881. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,881. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.22x the Medicare baseline. Located in 70 Dubois Street, Newburgh, NY.

Cash / Self-Pay

$2,881

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,881

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: $2,881 (122%)

Insurance Median: $2,881 (122%)

Cash: $2,881 (122% of Medicare)

Ins. Median: $2,881 (122% 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
Healthfirst	$1,395 - $3,516	59%
Magnacare	$1,500 - $3,000	64%
Affinity	$1,681 - $3,025	71%
Blue Cross Blue Shield	$1,681 - $5,240	71%
Emblem	$1,681 - $18,207	71%
Medicaid / KanCare	$1,681	71%
Hamaspik	$1,765 - $3,111	75%
Mediblue	$2,794	118%
Aetna	$2,852 - $5,843	121%
Cdphp	$2,881 - $6,410	122%
Fidelis	$2,881 - $3,342	122%
Hudson Valley	$2,881	122%
Oscar	$2,881 - $7,276	122%
Point Comfort	$2,881	122%
UnitedHealthcare	$2,881 - $6,801	122%
Villagecaremax	$2,881	122%
Vnsny Choice	$2,881	122%
Centerlight	$2,967	126%
Wellcare	$2,967	126%
Humana	$3,169	134%
Mvp	$5,223	222%
Seiu1199	$5,826	247%
Geha	$5,843	248%
Meritain Health	$5,843	248%
Nippon Life Insurance	$5,843	248%
American Postal Workers	$6,801	288%
Northwell	$7,749	329%

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 $2,881.
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 St Luke's Cornwall 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.