Alabama · 66982

Complex Removal Of Cataract With Insertion Of Prosthetic Lens in Alabama

Alabama Medicare Avg
$97.70
66% below national avg
National Medicare Avg
$287.18
All states combined
Billed Charge (AL)
$519.69
What providers submit
Est. Commercial (AL)
$272.05
National avg: $812.55
Est. Cash / Self-Pay (AL)
$235.66
Typical self-pay discount

Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.

13.8K
Services in AL
243
Providers
N/A
Min Payment
N/A
Max Payment

Top Providers in Alabama

Provider Medicare Services
Southern Alabama Surgery Center Llc $692.28 189
Heersink, Sebastian MD $491.06 133

Alabama Pricing in Context

In Alabama, CPT code 66982 (Complex Removal Of Cataract With Insertion Of Prosthetic Lens) carries an average Medicare payment of $97.70 — 66% below the national benchmark of $287.18. 243 providers across the state submitted claims for this procedure in 2023, performing 13.8K total services. Individual payments in AL ranged from N/A at the low end to N/A at the high end, reflecting differences in provider setting (office vs. facility), modifiers, and the specific geographic locality code applied within the state.

The average billed charge in Alabama is $519.69, which is the figure uninsured patients would most likely encounter before any negotiation or charity discount. Medicare, by statute, only reimburses the allowed amount — the balance between billed and paid is written off under provider participation agreements. Insured patients generally pay a negotiated rate that falls between these two figures; the exact amount depends on plan design, deductible status, and in-network participation. Because Alabama sits below the national Medicare average, commercial rates in the state may also run lower than the US median.

Using RAND 2024 commercial-to-Medicare ratios for Eye Surgery procedures, the estimated commercial insurance price in Alabama lands near $272.05, with self-pay cash prices typically around $235.66. Before scheduling, patients can request a Good Faith Estimate under the No Surprises Act, compare cash rates from hospital Machine-Readable Files, and confirm whether the provider is in-network with their specific plan. This page presents CMS reference data for informational use; it does not constitute medical or financial advice.

Frequently Asked Questions

How much does Complex Removal Of Cataract With Insertion Of Prosthetic Lens cost in Alabama?

The average Medicare payment for Complex Removal Of Cataract With Insertion Of Prosthetic Lens in Alabama is $97.70, which is 66% below the national average of $287.18. Providers in AL typically bill $519.69 for this procedure.

What does Complex Removal Of Cataract With Insertion Of Prosthetic Lens cost with insurance in Alabama?

With commercial insurance in Alabama, Complex Removal Of Cataract With Insertion Of Prosthetic Lens costs an estimated $272.05. Without insurance, the estimated cash price is $235.66. These estimates are based on RAND 2024 commercial-to-Medicare ratios and vary by insurer, plan, and facility.

How many providers perform Complex Removal Of Cataract With Insertion Of Prosthetic Lens in Alabama?

243 providers in Alabama billed Medicare for Complex Removal Of Cataract With Insertion Of Prosthetic Lens in 2023, performing 13.8K total services. Medicare payments ranged from N/A to N/A depending on the provider.

Is Complex Removal Of Cataract With Insertion Of Prosthetic Lens cheaper in Alabama than the national average?

Yes — Complex Removal Of Cataract With Insertion Of Prosthetic Lens costs 66% below the national average in Alabama. The state average Medicare payment is $97.70 compared to $287.18 nationally. Factors like local cost of living, provider competition, and regional Medicare fee schedules all influence state-level pricing.

Related

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure Editorial