CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Suny/Stony Brook University Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $2,895
Cash Discount Price: $15,596
vs. Medicare Baseline: 1.23x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Suny/Stony Brook University Hospital is $2,895. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $15,596. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.23x the Medicare baseline. Located in Health Sciences Center SUNY, Stony Brook, NY.

Cash / Self-Pay

$15,596

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,895

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: $15,596 (661%)

Insurance Median: $2,895 (123%)

Cash: $15,596 (661% of Medicare)

Ins. Median: $2,895 (123% 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
Aetna	$1,433 - $5,417	61%
Blue Cross Blue Shield	$1,433 - $7,040	61%
Elderplan	$1,433 - $2,867	61%
Fidelis Care	$1,433 - $2,867	61%
Healthfirst Health Plan	$1,433 - $2,867	61%
UnitedHealthcare	$1,433 - $12,338	61%
Emblemhealth Hip Of Ny	$1,462 - $6,608	62%
Agewell New York	$1,577 - $3,153	67%
Centerlight	$1,863 - $3,727	79%
Partners Health Plan	$1,863 - $3,727	79%
Emblemhealth Hip Of Ny Select Care	$4,958	210%
Cigna	$5,171	219%
Oxford Freedom And Liberty	$5,562	236%
Brighton All Payer	$6,468	274%

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 $15,596.
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 Suny/Stony Brook University 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.