CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Cleveland Clinic

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $1,602
Cash Discount Price: $2,055
vs. Medicare Baseline: 0.68x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Cleveland Clinic is $1,602. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,055. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.68x the Medicare baseline. Located in 9500 Euclid Avenue, Cleveland, OH.

Cash / Self-Pay

$2,055

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,602

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: $2,055 (87%)

Insurance Median: $1,602 (68%)

Cash: $2,055 (87% of Medicare)

Ins. Median: $1,602 (68% 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
Summacare	$324 - $2,114	14%
Aetna	$499 - $3,161	21%
Blue Cross Blue Shield	$499 - $3,968	21%
Devoted Health	$499 - $2,114	21%
Humana	$499 - $2,114	21%
The Health Plan	$499 - $2,114	21%
United	$499 - $6,238	21%
UnitedHealthcare	$499 - $2,114	21%
Upmc	$499 - $2,114	21%
Valor	$499 - $2,114	21%
Cigna	$514 - $8,233	22%
Communicare	$524 - $2,220	22%
Perennial Health	$539 - $2,283	23%
Pphp	$539 - $2,326	23%
Zing Health	$548 - $2,326	23%
Paramount	$560 - $1,419	24%
Buckeye	$571 - $1,447	24%
Caresource	$571 - $1,378	24%
Amerihealth	$598	25%
Molina	$598 - $1,447	25%
Oscar	$844	36%
Cc Ehp	$947	40%
Ohcp	$1,230	52%
Ohio Healthy	$1,264	54%
Aultcare	$1,359	58%
Amish Community Aid Plan	$1,422	60%
United Bh	$1,516	64%
Omas	$1,580	67%
Healthsmart	$1,739	74%
Phphi	$1,897	80%
Clarity Health	$2,055	87%
Mmo	$2,114 - $4,809	90%
Gms	$2,213	94%
Quality Care Partners	$2,213	94%
Consociate Health	$2,371	101%
Multiplan	$2,845	121%
Three Rivers	$2,845	121%
Usa Managed Care	$2,845	121%

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 $2,055.
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 Cleveland Clinic 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.