CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Frio Regional Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 66984
  • Insurance Median: $8,244
  • Cash Discount Price: $6,558
  • vs. Medicare Baseline: 3.50x Medicare
The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Frio Regional Hospital is $8,244. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,558. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 3.50x the Medicare baseline. Located in 200 S Ih 35, Pearsall, TX.
Cash / Self-Pay
$6,558

Average discount available for prompt cash payment at this facility.

Insurance Median
$8,244

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: $6,558 (278%)
Insurance Median: $8,244 (350%)
Cash: $6,558 (278% of Medicare)
Ins. Median: $8,244 (350% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 350% of the Medicare baseline (a markup of 250%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Cigna $2,047 87%
Amerigroup Texas $2,155 91%
Superior Health Plan $2,155 91%
Aetna $7,026 298%
Blue Cross Blue Shield $8,056 - $8,431 342%
UnitedHealthcare $8,619 366%
Choicecare $9,368 397%
Humana $9,368 397%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 S Ih 35, Pearsall, TX 78061
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals