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Delaware

Cost of a Cataract Surgery Visit
in Delaware

Reviewed by Momentary Medical Group West PC

Delaware's small but concentrated healthcare market, anchored by major systems like ChristianaCare and Bayhealth, creates a unique cost environment for surgical procedures. Cataract Surgery patients typically pay between $343 and $2,135, with a median out-of-pocket cost of $691 based on negotiated insurance rates. With 83 active Cataract Surgery providers serving the First State's nearly one million residents, patients can browse all available specialists across New Castle, Kent, and Sussex counties.

Average

$1,056

Median

$691

Lowest

$343

Highest

$2,135

Providers

83

National avg: $888Delaware: $1,056

19% above national average

Compare Similar Procedures

How does cataract surgery compare to related procedures in Delaware?

ProcedureCPTLowMedianHighProviders
Knee Replacement

Total knee replacement (arthroplasty)

27447$1,005$1,687$6,05178
Hip Replacement

Total hip replacement (arthroplasty)

27130$80$1,574$6,06091
Knee Arthroscopy

Arthroscopy of the knee with meniscectomy

29881$412$640$2,41080
Gallbladder Removal (Laparoscopic)

Laparoscopic cholecystectomy

47562$416$773$2,07381
Appendectomy (Laparoscopic)

Laparoscopic appendectomy

44970$80$622$1,89399
Hysterectomy (Laparoscopic)

Laparoscopic total hysterectomy

58571$85$1,038$3,20183
Septoplasty

Nasal septum repair

30520$449$726$2,16078
Tonsillectomy

Tonsillectomy, primary or secondary

42820$154$319$69882
Inguinal Hernia Repair

Inguinal hernia repair

49505$330$602$1,43579
Mastectomy

Partial or simple mastectomy

19301$95$705$2,64284
Carpal Tunnel Surgery

Open carpal tunnel release

64721$354$612$1,95777

Important: These are cost estimates only — not a quote and not medical advice.

The prices on this page are self-pay rates, drawn from federal Transparency in Coverage machine-readable files (CPT 66984Extracapsular cataract removal with insertion of intraocular lens). They represent what a patient might pay without insurance.

Your actual cost depends on: your specific insurance plan, your remaining deductible, your coinsurance percentage, whether you have met your out-of-pocket maximum, whether the facility and provider are both in-network, and any separate anesthesia or implant fees billed independently.

This page does not constitute medical advice. Whether you need this procedure, and which approach is right for you, is a decision to make with a licensed healthcare provider.

Where this data comes from & what CPT 66984 covers

Data source: Cost figures are derived from UnitedHealthcare Transparency in Coverage machine-readable files for CPT code 66984 (Extracapsular cataract removal with insertion of intraocular lens), as mandated by the CMS Price Transparency Rule.

What CPT 66984 covers: the provider's professional fee for cataract surgery. It does not include facility/hospital fees, anesthesia, pre-operative imaging, post-operative care, or any add-on codes billed separately.

How to read this data

Negotiated Rate

The discounted price an insurer has agreed to pay a specific provider. Most insured patients' bills are calculated from this number, not the higher list price hospitals publish separately.

P5, Median, P95

P5 is the rate at the 5th percentile (low end), Median is the middle value, and P95 is the 95th percentile (high end). This range shows how much the same visit can vary between providers.

What this does not tell you

These rates do not tell you what you personally will pay out of pocket. That depends on your specific plan, how much of your deductible you have already met, your coinsurance rate, and whether the provider is in your network. Call your insurer's member line to get your exact estimate.

Why Cataract Surgery Visit Costs Vary Across Delaware

Delaware's compact geography concentrates most specialty surgical care in the Wilmington-Newark corridor, creating cost premiums approximately 11% above national averages. The state's position in the Northeast megalopolis, bordered by higher-cost markets like Philadelphia and Baltimore, influences provider pricing and overhead expenses.

Urban vs. Rural Provider Availability

Most of Delaware's 83 Cataract Surgery providers practice in New Castle County near Wilmington and Newark, leaving residents of rural Kent and Sussex counties with limited local options. Patients from southern Delaware often travel to the Wilmington area or cross state lines to Maryland for specialized surgical care, which can impact both travel costs and scheduling flexibility. The concentration of providers in northern Delaware creates competitive pricing in that region while potentially limiting options for downstate residents.

Facility Type and Overhead Costs

ChristianaCare and Bayhealth dominate Delaware's hospital market, operating multiple outpatient surgical centers with higher overhead costs than independent facilities. Many Cataract Surgery procedures occur at dedicated ambulatory surgery centers like Delaware Eye Surgery Center, which typically offer lower facility fees than hospital-based outpatient departments. The state's proximity to major academic medical centers in Philadelphia also influences local pricing structures and referral patterns.

Insurance Market Competition in Delaware

Delaware's small market is served primarily by Highmark Blue Cross Blue Shield, Aetna, and UnitedHealthcare, creating moderate competition that keeps negotiated rates relatively stable. The state's lack of a major regional insurer means most plans are managed by national companies with standardized pricing models. Limited insurer competition contributes to Delaware's higher-than-average healthcare costs compared to more competitive state markets.

Physician Supply and Demand in Delaware

With 83 active Cataract Surgery providers serving nearly one million residents, Delaware maintains adequate specialist availability concentrated in the northern counties. This supply level creates reasonable access for most patients while supporting competitive pricing among providers in the Wilmington metropolitan area. However, the geographic concentration means patients in southern Delaware may face longer wait times and higher travel-related costs for specialized surgical care.

JP

Jayant Panwar

CEO, Momentary Labs · San Francisco, CA

Jayant has analyzed healthcare pricing data from CMS Transparency in Coverage files since 2022, covering more than 50 million negotiated rate records across all 50 states. His work focuses on making insurer machine-readable files accessible to patients and researchers.

The cost figures on this page reflect his ongoing work to make this data accessible to patients.

Healthcare Data AnalyticsCMS TiC DataInsurance Price Transparency

Frequently Asked Questions — Cataract Surgery Costs in Delaware

What is the average cost of a Cataract Surgery visit in Delaware without insurance?

Uninsured patients in Delaware typically pay between $343 and $2,135 for a Cataract Surgery consultation, with a median cost of $691 based on negotiated insurance rates. These fees cover the initial evaluation and diagnostic testing but do not include the surgical procedure itself. Many Delaware providers offer cash-pay discounts that can reduce these amounts by 20-40% for patients paying upfront.

Does Delaware Medicaid cover Cataract Surgery visits?

Yes, Delaware expanded Medicaid coverage includes Cataract Surgery consultations and procedures for eligible residents earning up to 138% of the federal poverty level. Coverage includes both the initial evaluation and medically necessary surgical treatment, though patients must use Medicaid-participating providers. Prior authorization may be required for certain diagnostic tests or premium intraocular lens options during surgery.

How do I find an affordable Cataract Surgery near me in Delaware?

Compare costs across Delaware's 83 Cataract Surgery providers by checking both independent ambulatory surgery centers and hospital-based practices, as fees can vary significantly. Many providers offer cash-pay discounts for uninsured patients, while insured patients should verify network status with Highmark, Aetna, or UHC before booking. Community health centers in Wilmington and Dover may offer sliding-scale fee options for qualifying patients.

What is the difference in cost between an initial consultation and a follow-up visit?

Initial Cataract Surgery consultations typically cost between $343-$2,135 with a median of $691, while follow-up visits generally range from $200-$400 depending on complexity and testing required. New patient visits involve comprehensive eye examinations and diagnostic imaging, while established patient visits focus on monitoring progression or post-operative care. Insurance copays may also differ between new and established patient visit types.

Can I use an HSA or FSA to pay for a Cataract Surgery visit in Delaware?

Yes, both HSA and FSA funds can be used for medically necessary Cataract Surgery consultations and procedures in Delaware. These accounts cover diagnostic testing, surgical fees, and prescription medications related to cataract treatment. Keep detailed receipts for reimbursement, as elective premium lens upgrades may have different eligibility requirements than basic medically necessary services.

How does telemedicine affect the cost of seeing a Cataract Surgery in Delaware?

Telemedicine consultations for post-operative follow-up visits typically cost 20-30% less than in-person appointments in Delaware. However, initial cataract evaluations require in-person examination and diagnostic testing that cannot be performed remotely. Some Delaware providers use telehealth for pre-operative consultations or post-surgical check-ins, which can reduce overall treatment costs and travel time for patients in rural Kent and Sussex counties.

Click a state to compare costs

Average Visit Cost

$351
$3,412

Office visit (CPT 66984)

Compare With Other States

RankStateAverage
1Wisconsin
Range: $80$10,062
$3,412
2Wyoming
Range: $667$2,130
$1,240
3Rhode Island
Range: $448$2,135
$1,181
4Massachusetts
Range: $403$2,078
$1,139
5Montana
Range: $85$2,744
$1,127
6Delaware
Range: $343$2,135
$1,056
7Nebraska
Range: $641$1,313
$1,055
8Washington
Range: $616$1,521
$1,034
9New Hampshire
Range: $528$1,548
$1,023
10New York
Range: $364$2,135
$1,005
11Colorado
Range: $85$2,114
$1,003
12New Mexico
Range: $474$1,551
$982
13Alaska
Range: $85$2,135
$972
14Georgia
Range: $93$2,005
$970
15Connecticut
Range: $70$2,135
$961
16Pennsylvania
Range: $85$2,135
$946
17Maine
Range: $643$1,123
$945
18North Carolina
Range: $390$1,609
$940
19California
Range: $85$1,401
$899
20Nevada
Range: $415$1,453
$892
21District of Columbia
Range: $414$1,311
$871
22Vermont
Range: $403$1,548
$865
23Iowa
Range: $85$1,313
$861
24Oregon
Range: $85$1,687
$858
25North Dakota
Range: $80$1,609
$812
26Mississippi
Range: $430$1,451
$806
27Minnesota
Range: $90$1,548
$800
28Utah
Range: $85$1,209
$791
29New Jersey
Range: $364$1,380
$790
30South Carolina
Range: $327$1,383
$785
31Illinois
Range: $418$1,200
$771
32Alabama
Range: $418$1,195
$767
33Idaho
Range: $85$1,348
$743
34Tennessee
Range: $418$1,090
$741
35Hawaii
Range: $85$1,386
$739
36Louisiana
Range: $226$1,345
$730
37South Dakota
Range: $95$1,313
$729
38West Virginia
Range: $85$1,409
$721
39Maryland
Range: $477$1,083
$714
40Kansas
Range: $502$912
$711
41Virginia
Range: $360$1,157
$710
42Indiana
Range: $70$1,385
$708
43Kentucky
Range: $85$1,313
$691
44Missouri
Range: $502$811
$680
45Ohio
Range: $335$1,087
$678
46Texas
Range: $85$1,210
$662
47Michigan
Range: $85$1,073
$645
48Arkansas
Range: $85$1,042
$624
49Arizona
Range: $448$898
$614
50Oklahoma
Range: $85$960
$525
51Florida
Range: $35$964
$351
Cataract Surgery in Other States