CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Baylor Scott & White Medical Center - Marble Falls

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $2,357
Cash Discount Price: $2,352
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Baylor Scott & White Medical Center - Marble Falls is $2,357. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,352. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.00x the Medicare baseline. Located in 810 W Highway 71, Marble Falls, TX.

Cash / Self-Pay

$2,352

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,357

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: $2,352 (100%)

Insurance Median: $2,357 (100%)

Cash: $2,352 (100% of Medicare)

Ins. Median: $2,357 (100% 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 - $2,055	36%
Baylor Scott & White Health Plan	$1,426 - $3,391	60%
UnitedHealthcare	$1,932 - $3,245	82%
Cigna	$2,015 - $8,848	85%
Humana	$2,055 - $9,150	87%
Triwest	$2,055	87%
Corvel	$2,153	91%
Prime Health Services	$2,153	91%
Midcoast	$2,156	91%
Quiktrip	$2,156	91%
American Health Plan	$2,158	92%
Healthspring	$2,158	92%
Procare Advantage	$2,158	92%
University Of Mary Hardin-Baylor	$2,273	96%
Independent Medical System	$2,352	100%
Curative	$2,548	108%
First Health	$2,744	116%
Bluebell Creameries	$2,940	125%
Healthsmart	$2,940 - $6,325	125%
Private Health Care System	$2,940	125%
Sedgwick	$3,072	130%
Three Rivers	$3,528	150%
Aetna	$12,483	529%

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 $2,352.
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 - Marble Falls 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.