CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Mon Health Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 66984
  • Insurance Median: $15,538
  • Cash Discount Price: $8,632
  • vs. Medicare Baseline: 6.59x Medicare
The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Mon Health Medical Center is $15,538. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,632. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 6.59x the Medicare baseline. Located in 1200 Jd Anderson Drive, Morgantown, WV.
Cash / Self-Pay
$8,632

Average discount available for prompt cash payment at this facility.

Insurance Median
$15,538

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: $8,632 (366%)
Insurance Median: $15,538 (659%)
Cash: $8,632 (366% of Medicare)
Ins. Median: $15,538 (659% 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 659% of the Medicare baseline (a markup of 559%). 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
Unison_Plan $603 26%
Gateway_Health_Plan $663 28%
Zelis_Other_Plan $1,897 80%
The_Health_Plan_Peia_Plan $2,090 89%
Aetna $2,232 - $14,690 95%
Blue Cross Blue Shield $2,232 - $10,824 95%
Health_South_Mountain_View_Plan $2,232 95%
Humana $2,232 - $16,526 95%
Medicare (plans) $2,232 95%
Paramount_Elite_Plan $2,232 95%
Uhc_Va_Plan $2,232 95%
Zelis_Group_Health_Plan $2,232 95%
Seven_Corners_Plan $4,465 189%
Maryland_Physicians_Care_Plan $12,085 - $12,853 513%
The_Health_Plan_Murray_Energy_Commercial_Aso_Plan $13,812 - $14,690 586%
The_Health_Plan_Plan $14,848 - $15,791 630%
Acpn_Plan $15,538 - $16,526 659%
Cigna $15,538 - $16,526 659%
Mon_County_Commission_Plan $15,538 - $16,526 659%
Uhc_Plan $15,538 - $16,526 659%
Health_Payors_Organization_Plan $15,884 - $16,893 674%
Uhc_Options_Ppo_Plan $16,056 - $17,077 681%
Multiplan_Phcs_Plan $16,402 - $17,444 696%
Mutual_Of_Omaha_Plan $16,402 - $17,444 696%
Geha_Plan $16,747 - $17,811 710%
Three_Rivers_Plan $16,747 - $17,811 710%
Uhc_Onenet_Ppo_Plan $16,747 - $17,811 710%
Upmc__Plan $16,747 - $17,811 710%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1200 Jd Anderson Drive, Morgantown, WV 26505
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals