CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Temple University Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $2,634
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.12x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Temple University Hospital is $2,634. 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 1.12x the Medicare baseline. Located in 3401 North Broad Street, Philadelphia, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,634

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: $2,634 (112%)

Ins. Median: $2,634 (112% 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 Caritas	$844	36%
Pennsylvania Health And Wellness	$1,345 - $2,668	57%
Health Partners Plans	$1,670 - $2,474	71%
Upmc Health Plan	$2,049 - $2,596	87%
Blue Cross Blue Shield	$2,426 - $10,801	103%
Humana	$2,426	103%
UnitedHealthcare	$2,426 - $6,368	103%
Innovage	$2,474	105%
Aetna	$2,498 - $5,992	106%
Cigna	$2,547 - $3,200	108%
Keystone First	$2,547 - $2,634	108%
Clover Health	$2,571	109%
Geisinger	$2,668 - $12,075	113%
Elder Health	$2,911	123%
Gateway Health Plan	$3,032	129%
Wtc Health Program	$3,032	129%
Naphcare	$3,639	154%
Oscar Health	$3,639	154%
Prime Health Services	$3,861	164%
Occunet	$4,002	170%

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 Temple University 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.