CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Othello Community Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 66984
  • Insurance Median: $5,170
  • Cash Discount Price: $4,847
  • vs. Medicare Baseline: 2.19x Medicare
The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Othello Community Hospital is $5,170. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,847. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 2.19x the Medicare baseline. Located in 315 North 14Th Avenue, Othello, WA.
Cash / Self-Pay
$4,847

Average discount available for prompt cash payment at this facility.

Insurance Median
$5,170

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: $4,847 (206%)
Insurance Median: $5,170 (219%)
Cash: $4,847 (206% of Medicare)
Ins. Median: $5,170 (219% 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 219% of the Medicare baseline (a markup of 119%). 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
Ambetter / Centene $2,747 - $2,779 117%
Amerigroup Mcaid $2,747 117%
Chp Mcaid $2,747 117%
Cocare - All Plans $2,747 117%
Gau - All Plans $2,747 117%
Kaiser - All Plans $2,747 117%
Molina Mcaid $2,747 117%
UnitedHealthcare $2,747 - $6,463 117%
Chp - All Other Plans $2,779 118%
Molina - All Other Plans $2,779 118%
Medicare (plans) $3,231 137%
Tricare $4,201 178%
Triwest - All Plans $4,201 178%
Asuris - All Plans $5,170 219%
Commercial Other - All Plans $5,170 219%
Hma - All Plans $5,170 219%
Hmso - All Plans $5,170 219%
Tpsc - All Plans $5,170 219%
Travelers - All Plans $5,170 219%
Veterans Admin - All Plans $5,170 219%
Blue Cross Blue Shield $5,429 230%
Cigna $5,752 244%
First Choice - All Plans $5,816 247%
Aetna $6,075 258%
Chp Mcr Adv $6,463 274%
Health Alliance Mcr Adv - All Plans $6,463 274%
Humana $6,463 274%
Molina Mcare $6,463 274%
Wellcare Mcr Adv - All Plans $6,463 274%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 315 North 14Th Avenue, Othello, WA 99344
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals