2024 Cataract Surgery Financial Considerations

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Cost is always an important consideration in any medical treatment. Below is a general idea of typical surgery-related costs that are the patient's responsibility AFTER insurance coverage:

Standard Lens  - Covered 

• Corrects vision at ONE distance (distance or near)
• Does not correct astigmatism  
• Coinsurance will apply for the actual procedure depending on your plan; see above 

Premium Lens 

Toric Lens - $1,500 per eye

• Corrects vision at one distance like the standard implant AND corrects astigmatism (abnormal curvature of cornea), increasing the chance for independence of glasses following surgery. 
• The amount you are responsible for accounts for the extra steps required during the procedure to prepare the implant for insertion and the lens itself
• Not covered by insurance 
• Considered a cosmetic enhancement by insurance companies

Premium Lens 

PanOptix Multifocal Lens - $2,500 per eye

• Corrects vision at multiple distances  AND corrects astigmatism (abnormal curvature of cornea), increasing the chance for independence of glasses following surgery. 
• The amount you are responsible for account for the extra steps required during the procedure to prepare the implant for insertion and the lens itself
• Not covered by insurance 
• Considered a cosmetic enhancement by insurance companies

Combination Drops, $70 per eye, not covered by insurance: Custom formulation to decrease the amount of drops taken per day and to decrease physical discomfort after surgery. Since this is a custom compounded medication it is not covered by insurance. Patients pay the office directly at their preoperative appointment. Drops are dispensed at the measurement appointment.

OR

Prescription Drops, cost is variable, may be covered by insurance: We can send a prescription to your preferred pharmacy for the required drops after surgery. They will be in three separate bottles. Cost is determined by each individual insurance plan. Anticipated cost is anywhere from $5-$60 per bottle (average $15-$180 per eye). 

Facility Fee The amount you are responsible for to use the facility after insurance coverage. 

• Each individual plan has a different amount, average is approximately $195-$398 per eye 
• Paid prior to date of surgery. 
•  Proliance Surgeons will contact you and go over their costs before your procedure.  
• Due in full before date of surgery. Payment plans available on a case-by-case basis.

Anesthesiologist (Pacific Anesthesia) - $ Variable 

• This is calculated by the minute. 
• Billed after surgery is performed. 

Patient’s scheduling surgery are responsible for knowing their specific plan limitations. 

Our office cannot give an accurate estimate because it has to be billed by insurance first and every plan is different. To get a better estimate of your out-of-pocket potential please call your insurance company customer service number on the back of your insurance card and ask what your anticipated expenses are for each service code below: 

Procedure: 66982, 66983, 66984, 66985, 66986  

Toric Lens Insertion: V2787    

Refraction (glasses prescription after surgery) 92015 

Ask your insurance company:   

• I am having cataract surgery, am I covered for (code)? 
• What is my out-of-pocket estimate for (code)?