CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Charleston Area Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $595
Cash Discount Price: $8,643
vs. Medicare Baseline: 0.25x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Charleston Area Medical Center is $595. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,643. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.25x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$8,643

Average discount available for prompt cash payment at this facility.

Insurance Median

$595

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: $8,643 (367%)

Insurance Median: $595 (25%)

Cash: $8,643 (367% of Medicare)

Ins. Median: $595 (25% 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
Aetna	$390 - $602	17%
The Health Plan Of West Virginia Inc.	$390 - $710	17%
Unicare Health Plan Of West Virginia Inc.	$390	17%
Triwest Va	$430	18%
Blue Cross Blue Shield	$444 - $868	19%
Choicecare Network	$444 - $595	19%
Optimum Choice Inc.	$444	19%
UnitedHealthcare	$444 - $457	19%
West Virginia Senior Advantage Inc.	$466	20%
City Of Charleston	$577	24%
Naphcare	$608	26%
Integrated Medical Solutions	$644	27%
Caresource	$666	28%
Tricare	$980	42%
Three Rivers Providers Network	$1,585	67%
Healthsmart	$1,601	68%
Multiplan	$1,601	68%
Cigna	$1,618	69%

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 $8,643.
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 Charleston Area Medical Center 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.