CMS Price Transparency Data
Cataract surgery with lens implant
Facility: Prisma Health Hillcrest Hospital
Billing Code: 66984 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 66984
- Insurance Median: $2,376
- Cash Discount Price: $3,461
- vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Prisma Health Hillcrest Hospital is $2,376. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,461. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.01x the Medicare baseline. Located in 741 South East Main Street, Simpsonville, SC.
Cash / Self-Pay
$3,461
Average discount available for prompt cash payment at this facility.
Insurance Median
$2,376
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: $3,461 (147%)
Insurance Median: $2,376 (101%)
Cash: $3,461 (147% of Medicare)
Ins. Median: $2,376 (101% 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 | $820 - $3,916 | 35% |
| UnitedHealthcare | $820 - $11,194 | 35% |
| Prisma Health Seniorcare Pace - Midlands [5400] | $1,235 | 52% |
| Prisma Health Seniorcare Pace-Upstate [5200] | $1,235 | 52% |
| Promise Health Plan Contracted [2401] | $1,863 - $3,194 | 79% |
| Tricare | $2,121 | 90% |
| Orangeburg Senior Helping Center Pace [5401] | $2,130 | 90% |
| Blue Cross Blue Shield | $2,145 - $6,550 | 91% |
| Sc Dept Of Corrections [2998] | $2,145 | 91% |
| Scdc-Sc Dept Of Corrections [7232] | $2,145 | 91% |
| Champva [3049] | $2,200 | 93% |
| Cigna | $2,200 - $3,695 | 93% |
| Covid19 Hrsa Uninsured Testing & Treatment Fund [904] | $2,200 | 93% |
| Deseret Mutual Ins Co [3066] | $2,200 | 93% |
| Generic Skilled Nursing [3196] | $2,200 | 93% |
| Hospice Contracted [1500] | $2,200 | 93% |
| Hospice Non Contracted [3190] | $2,200 | 93% |
| Medicare (plans) | $2,200 - $3,729 | 93% |
| Triwest Healthcare Alliance Vcp [902] | $2,200 | 93% |
| Va Community Care Network-Vaccn [903] | $2,200 | 93% |
| Veterans Administration [3194] | $2,200 | 93% |
| Humana | $2,213 - $3,990 | 94% |
| Aetna | $2,310 - $4,206 | 98% |
| Healthy Conn Prime-Wellcare Prime By Atc [5310] | $2,310 | 98% |
| Healthy Conn Prime-First Choice Vip Care [5300] | $2,332 | 99% |
| Healthy Conn Prime-Molina Healthcare [5330] | $2,420 | 103% |
| Workers Comp [600] | $3,080 | 131% |
| Bob Jones Univ-Pai [821] | $3,194 | 135% |
| Meritain Health Contracted [2200] | $3,407 - $4,206 | 144% |
| Evernorth Behavioral Contracted [2982] | $3,695 | 157% |
| Mvp Health Care [3037] | $3,695 | 157% |
| Preferred Administrators Contracted [2839] | $3,727 | 158% |
| First Choice Benefits Mgmt [3074] | $3,729 | 158% |
| Medcost [2940] | $3,940 - $4,419 | 167% |
| Atlantic Packaging Contracted [4833] | $3,993 | 169% |
| Ambetter / Centene | $4,048 | 172% |
| Bluechoice [810] | $4,225 - $6,913 | 179% |
| Aps Healthcare System [2981] | $4,259 | 181% |
| Multiplan/Phcs Contracted [2950] | $4,738 | 201% |
| Vsp Vision Care [2986] | $4,792 | 203% |
| First Health Contracted [2952] | $4,951 | 210% |
| Furman Int/Allen University Student [2951] | $4,951 | 210% |
| Quiktrip-First Health [3067] | $4,951 | 210% |
| Planned Administrators [820] | $6,550 | 278% |
| Golden Rule Insurance Company [2991] | $11,194 | 475% |
| Oxford Health Plans [2992] | $11,194 | 475% |
| Zzumr-Salt Lake City Ut [3169] | $11,194 | 475% |