CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Cleveland Clinic Avon Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $2,114
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.90x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Cleveland Clinic Avon Hospital is $2,114. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.90x the Medicare baseline. Located in 33300 Cleveland Clinic Blvd, Avon, OH.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,114

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%)

Insurance Median: $2,114 (90%)

Ins. Median: $2,114 (90% 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
Blue Cross Blue Shield	$1,115 - $2,114	47%
Buckeye	$1,115	47%
Molina	$1,115	47%
Caresource	$1,136	48%
United	$1,136 - $2,114	48%
Aetna	$2,114	90%
Devoted Health	$2,114	90%
Humana	$2,114	90%
Mmo	$2,114 - $2,178	90%
Summacare	$2,114	90%
The Health Plan	$2,114	90%
UnitedHealthcare	$2,114	90%
Upmc	$2,114	90%
Valor	$2,114	90%
Cigna	$2,178	92%
Communicare	$2,220	94%
Perennial Health	$2,283	97%
Pphp	$2,326	99%
Zing Health	$2,326	99%

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 $X.
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 Avon 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.