CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Univ. of Vermont - Fletcher Allen Health Care

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $1,699
Cash Discount Price: $2,242
vs. Medicare Baseline: 0.72x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Univ. of Vermont - Fletcher Allen Health Care is $1,699. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,242. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.72x the Medicare baseline. Located in 111 Colchester Ave, Burlington, VT.

Cash / Self-Pay

$2,242

Average discount available for prompt cash payment at this facility.

Insurance Median

$1,699

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: $2,242 (95%)

Insurance Median: $1,699 (72%)

Cash: $2,242 (95% of Medicare)

Ins. Median: $1,699 (72% 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
UnitedHealthcare	$352 - $2,396	15%
Mvp	$435 - $2,356	18%
Blue Cross Blue Shield	$440 - $3,596	19%
Aetna	$511 - $2,299	22%
Capital District Physicians' Health Plan	$511 - $2,299	22%
Humana	$511 - $2,299	22%
Martins Point	$511 - $2,356	22%
St. Regis	$511 - $2,299	22%
Veterans Affairs Community Care Network	$511 - $2,299	22%
Fidelis Care	$588 - $2,528	25%
Wellpath	$716 - $3,448	30%
Ebpa	$1,726	73%
Harvard Pilgrim	$1,794	76%
Magnacare	$1,794	76%
Coventry	$1,906	81%
Cigna	$1,952	83%
Nppn	$2,018	86%

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 $2,242.
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 Univ. of Vermont - Fletcher Allen Health Care 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.