CMS Price Transparency Data

Cataract surgery with lens implant

Facility: El Campo Memorial Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $2,141
Cash Discount Price: $6,011
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at El Campo Memorial Hospital is $2,141. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,011. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.91x the Medicare baseline. Located in 303 Sandy Corner Rd, El Campo, TX.

Cash / Self-Pay

$6,011

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,141

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: $6,011 (255%)

Insurance Median: $2,141 (91%)

Cash: $6,011 (255% of Medicare)

Ins. Median: $2,141 (91% 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
Aetna	$807 - $5,180	34%
Amerigroup	$807 - $2,141	34%
Community Health Choice	$807 - $2,395	34%
Molina	$807 - $2,281	34%
Texas Children'S Health Plan	$807 - $2,141	34%
UnitedHealthcare	$807 - $4,220	34%
Triwest	$1,312 - $2,281	56%
Blue Cross Blue Shield	$1,678 - $3,453	71%

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 $6,011.
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 El Campo Memorial Hospital 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.