CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Door County Medical Center

Billing Code: 66984 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$2,270

about 1.0× the $2,358 Medicare rate · typically $780–$5,993

modeled estimate · not a bill or quote

What this hospital charges insurers

$1,497

Below the fair price — a good deal

about $773 under the fair price · 0.6× Medicare

Medicare pays $2,358 Fair price $2,270 This hospital $1,497 Cash price $3,472 Hospital's list price $4,629

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

A typical price — 4 charge more and 4 charge less, among the 9 WI hospitals compared.

Cheapest $498 Priciest $2,176

Black dot = this hospital, among the 9 WI hospitals with a price for this procedure. Full list below.

A fair price for a Cataract surgery with lens implant is about $2,270 (about 1.0× the $2,358 Medicare rate). Door County Medical Center charges insurers about $1,497, or about $3,472 in cash — below the fair price — a good deal. Located in Sturgeon Bay, WI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$1,497 - $3,553	63%
Blue Cross Blue Shieldmajor	$1,497 - $3,908	63%
Aetnamajor	$1,497 - $4,166	63%
Cignamajor	$3,775	160%
Humanamajor	$400 - $1,497	17%
HealthPartners	$1,491	63%
+ 1 smaller / regional plan	$2,265

Government programs also on file: Medicare, Medicaid.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 3,472), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 66984.

Insurance Before you use insurance

Call your insurance company to confirm Door County Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 66984.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Door County Medical Center

Compare: Cataract surgery with lens implant at other WI hospitals

Insurance negotiated median for the same procedure, sorted lowest first.