CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Christus Spohn Hospital Alice

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $2,308
Cash Discount Price: Unavailable
vs. Medicare Baseline: 0.98x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Christus Spohn Hospital Alice is $2,308. 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 0.98x the Medicare baseline. Located in 2500 E Main Street, Alice, TX.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,308

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: $2,308 (98%)

Ins. Median: $2,308 (98% 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
Blue Cross Blue Shield	$850 - $4,165	36%
Molina	$850 - $2,308	36%
Superior	$850 - $2,308	36%
Driscoll Children'S Health Plan	$867	37%
UnitedHealthcare	$883 - $4,790	37%
Texas Childrens Health Plan	$892	38%
Aetna	$2,308 - $4,013	98%
Allwell	$2,308	98%
Christus Health	$2,308 - $3,232	98%
Coventry	$2,308	98%
Humana	$2,308 - $3,608	98%
Texas Healthspring	$2,308	98%
Triwest	$2,308	98%
Wellcare	$2,308	98%
Provider Partners Health Plan	$2,378	101%
Texas Independence Health Plan	$2,378	101%
Shared Health Insurance Company	$2,424	103%
Us Imaging Network	$2,470	105%
Amerigroup	$2,493	106%
Devoted Health Plan	$2,493	106%
Imperial Health Plan	$2,539	108%
Medicare (plans)	$2,539	108%
Procare Advantage	$2,539	108%
Healthcare Highways	$2,715	115%
Cigna	$3,257 - $3,983	138%
Five Point Credit Union	$4,020	170%
Naphcare Inc.	$4,617	196%

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 Christus Spohn Hospital Alice 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.