CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Westfield Memorial Hospital Inc

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $964
Cash Discount Price: $329
vs. Medicare Baseline: 0.41x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Westfield Memorial Hospital Inc is $964. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $329. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.41x the Medicare baseline. Located in 189 E Main St, Westfield, NY.

Cash / Self-Pay

$329

Average discount available for prompt cash payment at this facility.

Insurance Median

$964

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: $329 (14%)

Insurance Median: $964 (41%)

Cash: $329 (14% of Medicare)

Ins. Median: $964 (41% 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
Univera	$55 - $737	2%
Amerihealth	$633 - $2,834	27%
Highmark	$679 - $4,475	29%
Pennsylvania Health And Wellness	$795 - $2,481	34%
Cigna	$851	36%
Geisinger	$874 - $2,646	37%
UnitedHealthcare	$874 - $2,915	37%
Jefferson Health Plans	$922 - $2,531	39%
American Health Plans	$2,699	114%
Life Pittsburgh	$2,699	114%
Martin'S Point	$2,699	114%
Medicare (plans)	$2,780	118%
Aetna	$2,807 - $5,182	119%
Humana	$2,861	121%
Molina	$2,942	125%

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 $329.
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 Westfield Memorial Hospital Inc 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.