CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Galion Community Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $3,598
Cash Discount Price: $7,484
vs. Medicare Baseline: 1.53x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Galion Community Hospital is $3,598. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,484. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.53x the Medicare baseline. Located in 269 Portland Way South, Galion, OH.

Cash / Self-Pay

$7,484

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,598

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: $7,484 (317%)

Insurance Median: $3,598 (153%)

Cash: $7,484 (317% of Medicare)

Ins. Median: $3,598 (153% 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
Amerihealth	$494	21%
Blue Cross Blue Shield	$524 - $7,345	22%
Buckeye	$524 - $4,142	22%
Caresource	$524	22%
Humana	$524 - $4,142	22%
Medicaid / KanCare	$524	22%
Molina	$524 - $4,790	22%
Ohiorise	$524	22%
United_Healthcare	$550 - $6,807	23%
Medical_Mutual	$2,994 - $7,044	127%
Medicare (plans)	$2,994 - $4,142	127%
Mount_Carmel	$2,994 - $4,142	127%
Aetna	$3,054 - $8,805	130%
Cigna	$7,613	323%

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 $7,484.
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 Galion Community 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.