CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Independence Health System Butler Memorial Hospita

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $2,315
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Independence Health System Butler Memorial Hospita is $2,315. 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 Way, Butler, PA.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,315

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: $2,315 (98%)

Ins. Median: $2,315 (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
Medicaid / KanCare	$603	26%
UnitedHealthcare	$603 - $5,627	26%
Geisinger	$657 - $2,304	28%
Amerihealth	$663 - $2,304	28%
Jefferson Health Plan	$663	28%
Gateway	$681 - $2,463	29%
Upmc	$681 - $4,051	29%
Aetna	$693 - $5,046	29%
Ccbh - Behavioral Health	$1,102	47%
Highmark	$2,150 - $4,628	91%
Workers Comp	$2,157	91%
Life Butler County	$2,194	93%
Martin'S Point - Usfhp	$2,194	93%
Medicare (plans)	$2,194	93%
Peak Health	$2,194 - $5,156	93%
Provider Partners	$2,194	93%
Tricare	$2,194	93%
Humana	$2,282	97%
Devoted Health Plan	$2,326	99%
The Health Plan	$2,326 - $5,156	99%
Pa Health & Wellness	$2,348	100%
American Health Plan	$2,414	102%
Pnoa	$2,414 - $3,048	102%
Highmark Aca - Direct Blue	$2,892	123%
Ellwood Group	$4,388	186%
Highmark Community Blue	$4,537	192%
Cigna	$5,013	213%
Highmark - Ind.& Managed Care	$5,143	218%

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 Independence Health System Butler Memorial Hospita 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.