CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Clarion Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 66984
  • Insurance Median: $2,304
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.98x Medicare
The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Clarion Hospital is $2,304. 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 One Hospital Drive, Clarion, PA.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,304

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: $2,304 (98%)
Ins. Median: $2,304 (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.

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
Medicaid / KanCare $603 26%
Amerihealth $663 - $2,194 28%
Jefferson Health Plan $663 28%
Geisinger $729 - $2,304 31%
Upmc $753 - $4,050 32%
Highmark $2,172 - $3,640 92%
Highmark Community Blue $2,185 93%
Cigna $2,194 93%
Martin'S Point - Usfhp $2,194 93%
Medicare (plans) $2,194 93%
Tricare $2,194 93%
UnitedHealthcare $2,194 93%
Aetna $2,260 - $5,046 96%
Devoted Health Plan $2,326 99%
The Health Plan $2,326 - $5,156 99%
Gateway $2,348 100%
Pa Health & Wellness $2,348 100%
American Health Plan $2,414 102%
Workers Comp $3,048 129%
Highmark - Ind.& Managed Care $4,927 209%
Peak Health $5,156 219%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals