CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Valley Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 66984
  • Insurance Median: $4,840
  • Cash Discount Price: $16,790
  • vs. Medicare Baseline: 2.05x Medicare
The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Valley Medical Center is $4,840. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $16,790. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 2.05x the Medicare baseline. Located in 400 S 43Rd St, Renton, WA.
Cash / Self-Pay
$16,790

Average discount available for prompt cash payment at this facility.

Insurance Median
$4,840

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: $16,790 (712%)
Insurance Median: $4,840 (205%)
Cash: $16,790 (712% of Medicare)
Ins. Median: $4,840 (205% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 205% of the Medicare baseline (a markup of 105%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash 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
Great West [190102] $1,176 50%
Christian Brother Employee Benefit Trust [110100] $1,397 59%
Pacificsource [130122] $1,397 59%
Soundpath Health-Termed [210113] $2,111 90%
Humana $2,680 114%
UnitedHealthcare $2,680 - $4,840 114%
Benefit Md [150113] $4,840 205%
Carpenters Trust [150122] $4,840 205%
Cement Masons And Plasterers [150127] $4,840 205%
Coresource [150109] $4,840 205%
Employee Benefit Management Services [150108] $4,840 205%
Fc Moda Health [150139] $4,840 205%
First Choice Health Administrators [150110] $4,840 205%
First Choice Health Comp [150112] $4,840 205%
First Choice [150134] $4,840 205%
Health Net [150111] $4,840 205%
Here [150114] $4,840 205%
Hotel Employees Health Trust [150115] $4,840 205%
International Longshore & Warehouse Union [150116] $4,840 205%
Kitsap Physician Services [150118] $4,840 205%
Loomis Benefits West [150119] $4,840 205%
Mega [150120] $4,840 205%
Midwest [150121] $4,840 205%
Nw Administrators [150123] $4,840 205%
Operating Engineers [150125] $4,840 205%
Painters Trust [150126] $4,840 205%
Puget Sound Electric [150131] $4,840 205%
Seattle Plumb And Pipe [150132] $4,840 205%
Trusteed Plan [150101] $4,840 205%
United Employee Benefit Trust [150137] $4,840 205%
Washington Bakers Trust [150102] $4,840 205%
Washington Employers Trust [150103] $4,840 205%
Washington State Health Ins Pool [150104] $4,840 205%
Welfare Pension Administration Services [150105] $4,840 205%
Zenith Admin [150106] $4,840 205%
Zzjohn Alden [150117] $4,840 205%
Zzprincipal Financial Group [150128] $4,840 205%
Zzprovidence [150129] $4,840 205%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 400 S 43Rd St, Renton, WA 98055
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals