CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Southwestern Vermont Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $505
Cash Discount Price: $1,094
vs. Medicare Baseline: 0.21x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Southwestern Vermont Medical Center is $505. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,094. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.21x the Medicare baseline. Located in 100 Hospital Drive, Bennington, VT.

Cash / Self-Pay

$1,094

Average discount available for prompt cash payment at this facility.

Insurance Median

$505

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: $1,094 (46%)

Insurance Median: $505 (21%)

Cash: $1,094 (46% of Medicare)

Ins. Median: $505 (21% 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
Mvp	$396 - $758	17%
UnitedHealthcare	$396 - $707	17%
Bmc	$427	18%
Hne	$427 - $505	18%
Cdphp	$440 - $722	19%
Aetna	$505 - $1,034	21%
Blue Cross Blue Shield	$505 - $1,338	21%
Cigna	$505 - $881	21%
Fidelis	$505 - $530	21%
Humana	$505	21%
Wellcare	$505	21%
Health New England	$596	25%
Allegiance	$707	30%
Harvard Pilgrim	$877	37%
Tufts	$878	37%

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 $1,094.
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 Southwestern Vermont Medical Center 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.