CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Metrohealth System

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $3,665
Cash Discount Price: $2,012
vs. Medicare Baseline: 1.55x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Metrohealth System is $3,665. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,012. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.55x the Medicare baseline. Located in 2500 Metrohealth Drive, Cleveland, OH.

Cash / Self-Pay

$2,012

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,665

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: $2,012 (85%)

Insurance Median: $3,665 (155%)

Cash: $2,012 (85% of Medicare)

Ins. Median: $3,665 (155% 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
Medical Mutual	$1,189 - $8,683	50%
Aarp	$2,183	93%
Valor Health	$2,205	94%
Perennial Advantage	$2,227	94%
Mcgregor Pace	$2,402	102%
Aetna	$2,579 - $3,908	109%
Buckeye Health Plan	$2,838	120%
Caresource	$3,057	130%
Summacare	$3,665	155%
UnitedHealthcare	$4,054	172%
Health E Ohio	$4,585	194%
Blue Cross Blue Shield	$4,749 - $8,324	201%
Cigna	$5,334	226%
Clarity Health	$5,677	241%

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 $2,012.
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 Metrohealth System 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.