CMS Price Transparency Data

Cataract surgery with lens implant

Facility: West Penn Hospital

Billing Code: 66984 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$907

about 0.4× the $2,358 Medicare rate · typically $598–$1,499

modeled estimate · not a bill or quote

What this hospital charges insurers

$994

About the fair price

about $87 over the fair price · 0.4× Medicare

Medicare pays $2,358 Fair price $907 This hospital $994 Cash price $403 Hospital's list price $1,494

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

Highest price of the 9 PA hospitals we have prices for — worth calling around.

Cheapest $672 Priciest $994

Black dot = this hospital, among the 9 PA hospitals with a price for this procedure. Full list below.

A fair price for a Cataract surgery with lens implant is about $907 (about 0.4× the $2,358 Medicare rate). West Penn Hospital charges insurers about $994, or about $403 in cash — about the fair price. Located in Pittsburgh, PA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$874 - $7,699	37%
Blue Cross Blue Shieldmajor	$679 - $5,568	29%
Aetnamajor	$723 - $7,262	31%
Cignamajor	$851 - $7,280	36%
Humanamajor	$2,326	99%
AmeriHealth	$633 - $2,729	27%
Geisinger	$874 - $2,646	37%
Medical Mutual	$7,280	309%
Molina	$2,392	101%
+ 5 smaller / regional plans	$663 - $2,481

Government programs also on file: Medicare.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 403), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 66984.

Insurance Before you use insurance

Call your insurance company to confirm West Penn Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 66984.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

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Other Procedures at West Penn Hospital

Compare: Cataract surgery with lens implant at other PA hospitals

Insurance negotiated median for the same procedure, sorted lowest first.