CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Penn State Health Hampden Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $2,571
Cash Discount Price: $4,665
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Penn State Health Hampden Medical Center is $2,571. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,665. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.09x the Medicare baseline. Located in 2200 Good Hope Road, Enola, PA.

Cash / Self-Pay

$4,665

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,571

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: $4,665 (198%)

Insurance Median: $2,571 (109%)

Cash: $4,665 (198% of Medicare)

Ins. Median: $2,571 (109% 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]	$1,917 - $2,256	81%
[Highmark Wholecare]	$1,917 - $2,256	81%
[Geisinger]	$2,030 - $9,894	86%
[Health Partners Plans]	$2,098 - $2,301	89%
[Pa Health & Wellness]	$2,109 - $2,323	89%
[Highmark]	$2,233 - $9,640	95%
UnitedHealthcare	$2,256 - $9,251	96%
[Cbc]	$2,256 - $7,405	96%
Aetna	$2,278 - $8,908	97%
Humana	$2,278	97%
[Healthspring]	$2,278	97%
[Upmc]	$2,301 - $10,953	98%
[Point Comfort Underwriters]	$2,819	120%
[Highmark Choice Blue]	$7,712	327%
[Highmark Aca]	$8,098	343%
Cigna	$9,095	386%
[Preferred Healthcare Systems]	$11,119	472%
[First Health]	$11,860	503%
[Multiplan]	$11,860	503%

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 $4,665.
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 Penn State Health Hampden Medical Center 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.