CMS Price Transparency Data

Cataract surgery with lens implant

Facility: St David's South Austin Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $4,408
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.87x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at St David's South Austin Medical Center is $4,408. 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 1.87x the Medicare baseline. Located in 901 West Ben White Blvd, Austin, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,408

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: $4,408 (187%)

Ins. Median: $4,408 (187% 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
Amerigroup	$811	34%
St David’S Hospice	$850	36%
Blue Cross Blue Shield	$892 - $5,237	38%
United	$912 - $10,285	39%
Superior Health Plan	$929	39%
Molina Healthcare	$935	40%
Humana	$1,062	45%
Sendero	$1,062	45%
Aetna	$1,190 - $5,457	50%
Evry Health	$3,270	139%
Nomi Health	$4,152 - $4,370	176%
Curative Administrators	$4,807	204%
Moda	$4,836	205%
Oscar	$5,014 - $5,926	213%
Healthcare Highways	$5,414 - $5,524	230%
Harbor Health Team	$5,675	241%
Moda Health	$5,927 - $6,046	251%
Cigna	$7,224 - $9,220	306%

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 $X.
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 St David's South Austin 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.