CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Porter Hospital Inc

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $2,167
Cash Discount Price: $3,650
vs. Medicare Baseline: 0.92x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Porter Hospital Inc is $2,167. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $3,650. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.92x the Medicare baseline. Located in 115 Porter Drive, Middlebury, VT.

Cash / Self-Pay

$3,650

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,167

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: $3,650 (155%)

Insurance Median: $2,167 (92%)

Cash: $3,650 (155% of Medicare)

Ins. Median: $2,167 (92% 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
Fidelis Care	$1,544	65%
Aetna	$1,716	73%
Capital District Physicians' Health Plan	$1,716 - $3,044	73%
Martins Point	$1,716	73%
Mvp	$1,716 - $3,402	73%
UnitedHealthcare	$1,716 - $3,614	73%
Veterans Affairs Community Care Network	$1,716	73%
Veterans Choice	$1,716	73%
Blue Cross Blue Shield	$1,752 - $2,847	74%
Wellpath	$2,008	85%
Humana	$2,167	92%
Harvard Pilgrim	$2,920	124%
Coventry	$3,212	136%
Cigna	$3,320	141%
Medical Corporation	$3,468	147%
Multiplan	$3,468	147%

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 $3,650.
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 Porter Hospital Inc 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.