CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Cincinnati Children's Hospital Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 66984
  • Insurance Median: $3,606
  • Cash Discount Price: $3,171
  • vs. Medicare Baseline: 1.53x Medicare
The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Cincinnati Children's Hospital Medical Center is $3,606. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,171. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.53x the Medicare baseline. Located in 3333 Burnet Avenue, Cincinnati, OH.
Cash / Self-Pay
$3,171

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,606

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: $3,171 (134%)
Insurance Median: $3,606 (153%)
Cash: $3,171 (134% of Medicare)
Ins. Median: $3,606 (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.

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
Aetna $318 - $6,218 13%
Humana $334 - $571 14%
Wellcare_Ky $334 - $445 14%
United_Health_Care_Ky $336 - $447 14%
Blue Cross Blue Shield $369 - $5,032 16%
Caresource_In $387 - $516 16%
Passport_Ky $441 19%
Caresource_Oh $485 - $571 21%
Amerihealth_Caritas_Oh $499 - $587 21%
Molina_Oh $508 - $598 22%
Buckeye_Oh $531 - $625 23%
United_Health_Care_Oh $578 - $679 25%
United_Health_Care_Insurance $1,952 - $3,402 83%
Caresource_Oh_Insurance $3,109 132%
Medical_Mutual_Of_Ohio_Insurance $3,330 - $5,658 141%
Parkview_Signature_Care_Insurance $3,811 - $4,483 162%
Point_Comfort_Insurance $4,042 171%
Margaret_Mary_Health_Insurance $4,123 - $4,850 175%
Cigna $4,228 - $4,974 179%
Health_Ohio_Network_Insurance $4,974 - $5,907 211%
Beechstreet_Insurance $5,021 - $5,907 213%
Evolutions_Health_Care_Systems $5,596 237%
Galaxy_Health_Insurance $5,596 237%
Custom_Design_Benefits_Insurance $5,907 251%
First_Health_Group_Insurance $5,907 251%
Health_Link_Insurance $5,907 251%
Health_Smart_Preferred_Insurance $5,907 251%
Medical_Benefit_Administrators_Insurance $5,907 251%
Ohio_Health_Choice_Insurance $5,907 251%
Private_Health_Care_Systems_Insurance $6,218 264%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3333 Burnet Avenue, Cincinnati, OH 45229
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens