CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Nationwide Children's Hospital Toledo, LLC

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $1,507
Cash Discount Price: $1,736
vs. Medicare Baseline: 0.64x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Nationwide Children's Hospital Toledo, LLC is $1,507. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,736. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.64x the Medicare baseline. Located in 2213 Cherry Street, Toledo, OH.

Cash / Self-Pay

$1,736

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,507

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: $1,736 (74%)

Insurance Median: $1,507 (64%)

Cash: $1,736 (74% of Medicare)

Ins. Median: $1,507 (64% 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
Mcclaren Health Plan - Michigan	$354 - $2,429	15%
Caresource	$445 - $2,476	19%
Paramount	$445	19%
Blue Cross Blue Shield	$467 - $1,507	20%
Tricare	$474 - $2,167	20%
Front Path Health Coalition	$578 - $7,073	25%
Mcclaren Health Plan	$623	26%
Aetna	$1,041	44%
UnitedHealthcare	$1,158 - $1,492	49%
Molina	$1,492 - $2,737	63%
Amerihealth	$1,507	64%
Bchp	$1,507	64%
Humana	$1,507	64%
Ohc	$2,170	92%
Ohio Ppo Connect	$2,170	92%
Mmo	$2,894	123%

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 $1,736.
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 Nationwide Children's Hospital Toledo, LLC 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.