CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Baylor Scott & White Medical Center - Round Rock

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $3,405
Cash Discount Price: $4,302
vs. Medicare Baseline: 1.44x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Baylor Scott & White Medical Center - Round Rock is $3,405. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,302. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.44x the Medicare baseline. Located in 300 University Blvd, Round Rock, TX.

Cash / Self-Pay

$4,302

Average discount available for prompt cash payment at this facility.

Insurance Median

$3,405

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: $4,302 (182%)

Insurance Median: $3,405 (144%)

Cash: $4,302 (182% of Medicare)

Ins. Median: $3,405 (144% 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	$66 - $3,639	3%
Superior Health Plan	$850 - $2,084	36%
Baylor Scott & White Health Plan	$1,980 - $3,439	84%
Humana	$2,084 - $9,150	88%
Triwest	$2,084	88%
Corvel	$2,184	93%
Prime Health Services	$2,184	93%
Aetna	$2,189 - $12,483	93%
American Health Plan	$2,189	93%
Healthspring	$2,189	93%
Procare Advantage	$2,189	93%
UnitedHealthcare	$2,397 - $6,349	102%
Injury Management Organization	$2,589	110%
Careworks Fka Rockport	$3,116	132%
Sedgwick	$3,116	132%
Cigna	$3,405 - $8,848	144%
Midcoast	$3,943	167%
Quiktrip	$3,943	167%
University Of Mary Hardin-Baylor	$4,158	176%
Independent Medical System	$4,302	182%
Curative	$4,660	198%
First Health	$5,019	213%
Bluebell Creameries	$5,377	228%
Healthsmart	$5,377 - $6,325	228%
Private Health Care System	$5,377	228%
Three Rivers	$6,452	274%

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 $4,302.
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 Baylor Scott & White Medical Center - Round Rock 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.