CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Rio Grande Regional Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 66984
  • Insurance Median: $4,226
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.79x Medicare
The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Rio Grande Regional Hospital is $4,226. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.79x the Medicare baseline. Located in 101 E Ridge Rd, McAllen, TX.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,226

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%)
Insurance Median: $4,226 (179%)
Ins. Median: $4,226 (179% 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
Texas Health Network $841 36%
Driscoll Children'S Health Plan $875 37%
United $912 - $12,635 39%
Usa Managed Care $928 39%
Molina Healthcare $935 40%
Superior Health Plan $948 40%
Aetna $1,073 - $5,765 46%
Healthcare Highways $3,041 129%
Blue Cross Blue Shield $3,821 - $5,317 162%
Curative Administrators $4,807 204%
Humana $5,055 214%
Oscar $5,830 247%
Independent Medical System $7,227 307%
Cigna $7,684 - $10,274 326%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 101 E Ridge Rd, McAllen, TX 78503
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals