CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Guadalupe Regional Medical Center

Billing Code: 66984 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$2,189

about 0.9× the $2,358 Medicare rate · typically $1,753–$2,955

modeled estimate · not a bill or quote

What this hospital charges insurers

$2,220

About the fair price

about $31 over the fair price · 0.9× Medicare

Medicare pays $2,358 Fair price $2,189 This hospital $2,220 Cash price $4,554 Hospital's list price $9,108

How we calculate the fair BaseRate →

How this hospital compares to other TX hospitals

Highest price of the 9 TX hospitals we have prices for — worth calling around.

Cheapest $545 Priciest $2,220

Black dot = this hospital, among the 9 TX hospitals with a price for this procedure. Full list below.

A fair price for a Cataract surgery with lens implant is about $2,189 (about 0.9× the $2,358 Medicare rate). Guadalupe Regional Medical Center charges insurers about $2,220, or about $4,554 in cash — about the fair price. Located in Seguin, TX.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$6,568 - $7,500	279%
Blue Cross Blue Shieldmajor	$2,286 - $2,997	97%
Aetnamajor	$498 - $8,500	21%
Cignamajor	$7,881 - $9,000	334%
Humanamajor	$7,443 - $8,500	316%
Clover Health	$498 - $2,220	21%
Healthcare Highways	$6,568 - $7,500	279%
Oscar Health	$498 - $2,220	21%
WellCare	$498 - $2,220	21%
+ 4 smaller / regional plans	$498 - $9,000

Government programs also on file: Military & VA.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 4,554), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 66984.

Insurance Before you use insurance

Call your insurance company to confirm Guadalupe Regional Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 66984.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

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Other Procedures at Guadalupe Regional Medical Center

Compare: Cataract surgery with lens implant at other TX hospitals

Insurance negotiated median for the same procedure, sorted lowest first.