CMS Price Transparency Data

Cataract surgery with lens implant

Facility: UPMC McKeesport Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $2,316
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at UPMC McKeesport Hospital is $2,316. 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 0.98x the Medicare baseline. Located in 1500 Fifth Avenue, Mc Keesport, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,316

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: $2,316 (98%)

Ins. Median: $2,316 (98% 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
UnitedHealthcare	$663	28%
Upmc Health Plan	$663 - $5,156	28%
Highmark Wholecare (Prev Gateway)	$894 - $2,348	38%
Amerihealth Caritas	$941 - $2,348	40%
Pa Health & Wellness	$1,027 - $2,348	44%
Blue Cross Blue Shield	$1,458 - $7,362	62%
Aetna	$2,283 - $2,392	97%
Upmc Work Partners	$3,123	132%

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 UPMC McKeesport 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.