CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Saint Vincent Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $874
Cash Discount Price: $269
vs. Medicare Baseline: 0.37x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Saint Vincent Hospital is $874. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $269. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.37x the Medicare baseline. Located in 232 West 25Th Street, Erie, PA.

Cash / Self-Pay

$269

Average discount available for prompt cash payment at this facility.

Insurance Median

$874

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: $269 (11%)

Insurance Median: $874 (37%)

Cash: $269 (11% of Medicare)

Ins. Median: $874 (37% 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
Univera	$55 - $737	2%
Amerihealth	$633 - $2,729	27%
Aetna	$663 - $5,052	28%
Highmark	$679 - $3,620	29%
University Of Pittsburgh Medical Center	$693 - $3,471	29%
Pennsylvania Health And Wellness	$795 - $2,481	34%
Highmark Wholecare	$831 - $2,630	35%
Cigna	$851 - $5,295	36%
Geisinger	$874 - $2,646	37%
UnitedHealthcare	$874 - $67,023	37%
Jefferson Health Plans	$922 - $2,531	39%
American Health Plans	$2,481	105%
Life Pittsburgh	$2,481	105%
Martin'S Point	$2,481	105%
Medicare (plans)	$2,556	108%
Blue Cross Blue Shield	$2,605 - $3,911	110%
Humana	$2,630	112%
Molina	$2,705	115%
Medical Mutual	$5,295	225%

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 $269.
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 Saint Vincent 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.