CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Erlanger Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $889
Cash Discount Price: $720
vs. Medicare Baseline: 0.38x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Erlanger Medical Center is $889. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $720. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.38x the Medicare baseline. Located in 975 E 3Rd St, Chattanooga, TN.

Cash / Self-Pay

$720

Average discount available for prompt cash payment at this facility.

Insurance Median

$889

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: $720 (31%)

Insurance Median: $889 (38%)

Cash: $720 (31% of Medicare)

Ins. Median: $889 (38% 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
UnitedHealthcare	$504 - $2,197	21%
Humana	$522 - $2,092	22%
Blue Cross Blue Shield	$570 - $2,554	24%
Cigna	$614 - $2,092	26%
Amerigroup	$618 - $1,480	26%
Caresource	$644 - $4,184	27%
Peach State Hlth Plan	$644	27%
Alexian	$686 - $2,092	29%
Bluecare	$686 - $2,176	29%
Clover	$686 - $2,092	29%
Medicare (plans)	$686	29%
Upmc	$686 - $2,092	29%
Aetna	$690 - $2,155	29%
Pruitthealth Premier	$703	30%
American Health	$707 - $2,155	30%
Devoted Health	$714 - $2,176	30%
Nhc	$721 - $2,197	31%
Atrio Health	$755 - $2,301	32%
Simpra Advantage	$755	32%
Ambetter / Centene	$858 - $2,615	36%
Caresource Ga	$962 - $1,725	41%
Caresource Tn	$962 - $1,725	41%
Olympus	$1,030 - $1,167	44%
Alliant	$1,098	47%
Caresource Nc	$1,161 - $1,725	49%
Occunet	$1,201 - $1,988	51%
Point Comfort Underwriters	$1,205 - $1,236	51%
Pnoa	$1,364 - $5,230	58%
Wellpoint	$2,026	86%

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 $720.
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 Erlanger 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.