CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Fort Memorial Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $2,198
Cash Discount Price: $2,690
vs. Medicare Baseline: 0.93x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Fort Memorial Hospital is $2,198. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,690. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.93x the Medicare baseline. Located in 611 Sherman Ave E, Fort Atkinson, WI.

Cash / Self-Pay

$2,690

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,198

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: $2,690 (114%)

Insurance Median: $2,198 (93%)

Cash: $2,690 (114% of Medicare)

Ins. Median: $2,198 (93% 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
Molina	$528 - $2,198	22%
UnitedHealthcare	$656 - $2,198	28%
Blue Cross Blue Shield	$715 - $3,138	30%
Dean Health Plan	$715 - $13,459	30%
Medicaid / KanCare	$715	30%
Quartz	$715 - $5,312	30%
Managed Health Services	$779	33%
Group Health Cooperative	$957 - $5,380	41%
Fort Care	$1,622	69%
Humana	$2,198 - $8,014	93%
Medicare (plans)	$2,198	93%
Veteran Evaluation Services	$2,697	114%
Aetna	$3,354 - $6,237	142%
Centivo	$5,178 - $5,394	220%
Alliance	$5,968	253%
Mercycare	$6,192	263%
Trilogy	$7,313	310%
Cigna	$7,902	335%

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 $2,690.
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 Fort Memorial Hospital 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.