Cataract Surgery Cost in Worcester, MA (2026): Average Prices & What You'll Pay
What does a cataract surgery cost in Worcester, MA?
You could pay $3,587 or $18,628 for the same cataract surgery in Worcester, MA - depending entirely on which facility you choose. The median cash price across 5 reporting hospitals is $9,170. This data comes directly from hospital price transparency files published under federal law. Pick your coverage in the tabs below to see your number.
Insurance
With commercial insurance, cataract surgery in Worcester, MA typically runs $3,587–$18,628, facility and physician fees combined. What you pay out of pocket depends on your deductible and coinsurance.
Medicare
Medicare pays the same national rate to every provider that accepts it, adjusted slightly for local wages, so choosing a different hospital doesn't change what Medicare pays. For cataract surgery that rate is about $2,358–$4,223 (typically near $2,358). After the $257 Part B deductible you generally pay 20% of the approved amount, about $472.
Read the full Medicare coverage guide →
Your personalized cost report includes:
- ✓ Why the standard lens is covered but a toric/multifocal upgrade is billed directly to you
- ✓ The four separate bills (facility, surgeon, anesthesia, lens) and which to scrutinize
- ✓ Why an ambulatory surgery center usually costs less than a hospital for the identical operation
- ✓ How anesthesia ends up out-of-network even at an in-network surgery center
- ✓ A real patient billing breakdown, line by line
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Medicaid
Medicaid is run by each state, and it pays fixed rates to the providers that accept it, so the price doesn't change from one hospital to the next. Most people on Medicaid owe nothing or a small copay for covered care, but what's covered and what you owe depends on your state and plan. CostKits doesn't show a Medicaid price here because those rates are set by the state, not negotiated by each hospital. The question that matters is whether the provider accepts your Medicaid plan, so ask before you schedule.
Your personalized cost report includes:
- ✓ Why the standard lens is covered but a toric/multifocal upgrade is billed directly to you
- ✓ The four separate bills (facility, surgeon, anesthesia, lens) and which to scrutinize
- ✓ Why an ambulatory surgery center usually costs less than a hospital for the identical operation
- ✓ How anesthesia ends up out-of-network even at an in-network surgery center
- ✓ A real patient billing breakdown, line by line
Free for patients - takes 30 seconds to get.
We'll send a sign-in link to your email — click it to get your guide. No account required, no spam.
No insurance
Posted cash prices for cataract surgery at 5 Worcester, MA hospitals range from $1,513–$21,456, with a median of $9,170. The lowest posted price we found is UMass Memorial Medical Center at $9,170. Ask for the cash or self-pay price and for the hospital’s financial-assistance policy before you book.
Once you have a bill or an appointment on the calendar, CostKits can help you keep it all organized.
Where cataract surgery costs vary in Worcester, MA
Pins show hospitals with price-transparency data (colored by vs. state average) and nearby ambulatory surgery centers and other facilities (colored by type). Click any pin for facility name and estimated cost range.
26+ people checked prices near them this month.
Insurance covers cataract surgery - but the premium lens it won't cover can add $1,500–$3,000 per eye.
Your personalized cost report includes:
- ✓ Why the standard lens is covered but a toric/multifocal upgrade is billed directly to you
- ✓ The four separate bills (facility, surgeon, anesthesia, lens) and which to scrutinize
- ✓ Why an ambulatory surgery center usually costs less than a hospital for the identical operation
- ✓ How anesthesia ends up out-of-network even at an in-network surgery center
- ✓ A real patient billing breakdown, line by line
Free for patients - takes 30 seconds to get.
We'll send a sign-in link to your email - click it to get your guide. No account required, no spam.
Cheapest Cataract Surgery Providers in Worcester, MA
Based on declared cash/self-pay prices from CMS hospital price transparency files.
| # | Facility | City | Price | vs Median |
|---|---|---|---|---|
| 1 | HENRY HEYWOOD MEMORIAL HOSPITAL | Gardner, MA | $2,191 | -$6,979 |
| 2 | UMass Memorial Medical Center | MA | $9,170 | +$0 |
| 3 | UMass Memorial Health - Harrington Hospital, Inc. | MA | $20,993 | +$11,823 |
| 4 | HealthAlliance - Clinton Hospital | MA | $21,764 | +$12,594 |
Prices are declared self-pay rates. Contact each facility for a formal quote before scheduling.
Before you book: three questions that change the price
- Is this the self-pay price, and does it include the doctor, anesthesia and any lab or pathology? Those are often billed separately.
- Can you give me the price in writing, with the billing codes it covers?
- What happens to the price if something extra is needed during the procedure?
Estimate your out-of-pocket cost → · When the bills arrive, we check them for errors →
Quick take
- HENRY HEYWOOD MEMORIAL HOSPITAL is the lowest-cost option at $2,191 - $6,979 below the state median, just by choosing where you go.
- Ask for the cash price if your deductible isn't met - the median cash price here is $9,170, and it's often lower than what insurance pays before your deductible is satisfied.
- This dataset covers hospitals only - freestanding ASCs, which routinely run 30-60% cheaper for the same procedure, aren't included, so it's worth asking your doctor whether one is an option.
| Coverage | Hospitals with a rate | Typical range | Median |
|---|---|---|---|
| Medicare (national rate) | — | $2,358 to $4,223 | $2,358 |
| With insurance (commercial, average) | 3 | $7,001 to $9,638 | $8,240 |
| Without insurance (cash price) | 5 | $1,513 to $21,456 | $9,170 |
| Blue Cross Blue Shield of Massachusetts | 3 | $7,011 to $9,089 | $8,828 |
| UnitedHealthcare | 3 | $2,940 to $2,956 | $2,940 |
| Cigna | 3 | $5,410 to $14,190 | $11,223 |
Rates are negotiated allowed amounts and cash prices from hospital price-transparency files (October 2026), shown at each hospital’s lowest-priced typical billing code for this procedure. Facility fees only. The typical range is the middle 80% of hospitals, not a quote for your visit.
How much does a cataract surgery cost with Medicare in Worcester, MA?
Medicare's national hospital outpatient payment for cataract surgery is about $2,358 to $4,223 (typically near $2,358). After the $257 Part B deductible, you generally pay 20% of the Medicare-approved amount, about $472 on a $2,358 payment, with no out-of-pocket cap unless you have supplemental coverage or a Medicare Advantage plan.
Doctor, anesthesia and pathology fees are billed separately. Medicare rates are national CMS amounts, adjusted slightly by local wage levels.
How much does a cataract surgery cost with insurance in Worcester, MA?
Across 3 Worcester, MA hospitals, the negotiated rates commercial insurers pay for cataract surgery average $7,001 to $9,638 per hospital, with a median near $8,240. That is the amount your plan and you pay the hospital together; you owe your deductible, then coinsurance, up to your out-of-pocket maximum.
Each hospital’s figure is the average of the commercial insurers it lists. Medicare, Medicare Advantage and Medicaid rates are excluded.
How much does a cataract surgery cost without insurance in Worcester, MA?
Cash (self-pay) prices for cataract surgery at 5 Worcester, MA hospitals range from $1,513 to $21,456, with a median of $9,170. Ask for the cash or self-pay price and for any financial-assistance discount before you book; both can be lower than the posted price.
Cash prices are the hospital’s published discounted rate for patients paying without insurance.
How much does a cataract surgery cost with Blue Cross Blue Shield of Massachusetts in Worcester, MA?
Blue Cross Blue Shield of Massachusetts negotiated rates for cataract surgery at 3 Worcester, MA hospitals range from $7,011 to $9,089, with a median near $8,828. Your own cost depends on your plan’s deductible and coinsurance, and on whether the hospital is in your network.
Includes Blue Cross and Blue Shield and Anthem plans listed by each hospital.
How much does a cataract surgery cost with UnitedHealthcare in Worcester, MA?
UnitedHealthcare negotiated rates for cataract surgery at 3 Worcester, MA hospitals range from $2,940 to $2,956, with a median near $2,940. If a hospital is out of network for your UnitedHealthcare plan, you may owe more than the negotiated rate, so check the network first.
How much does a cataract surgery cost with Cigna in Worcester, MA?
Cigna negotiated rates for cataract surgery at 3 Worcester, MA hospitals range from $5,410 to $14,190, with a median near $11,223. If a hospital is out of network for your Cigna plan, you may owe more than the negotiated rate, so check the network first.
Massachusetts has the highest commercial hospital reimbursement rates in the country, driven by extreme labor costs, the dominance of Mass General Brigham (Partners HealthCare), and a regulatory environment that has struggled to contain negotiated rate growth. The state has enacted multiple price transparency and rate growth laws aimed at curbing this pattern. Self-pay cash discounts in Massachusetts tend to be proportionally larger than in other high-cost states. Medicare covers cataract surgery at a defined allowed amount wage-adjusted for your location - the main cost variable isn't geography but lens type. Standard monofocal lenses are fully covered; premium multifocal or toric lenses add $1,500–$3,000 per eye out-of-pocket regardless of insurance. Ambulatory surgery centers consistently charge less than hospital outpatient departments for the identical procedure.
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Why prices vary - and what it means for your coverage
Facility classification matters as much as the hospital itself - a hospital-owned outpatient center adds a facility fee that a freestanding clinic does not. Setting drives most of the spread here: an ambulatory surgical center (ASC) is usually meaningfully cheaper than a hospital operating room for the same procedure, when your case qualifies.
None of the prices above are what you'll necessarily owe: your deductible, out-of-pocket maximum, and each provider's network status all still apply.
| Your situation | Estimated out-of-pocket |
|---|---|
| Deductible not yet met | ~$9,170 |
| Deductible met - 20% coinsurance | ~$1,834 |
| Out-of-network provider | $20,174+ |
Frequently asked questions: cataract surgery costs in Worcester, MA
How much does a cataract surgery cost in Worcester, MA?
The typical price is $9,170, with most facilities between $3,587 and $18,628. Full market pricing - including cash rates, gross charges, and outlier facilities - ranges more widely, from $1,061 to $21,764 across all 5 Worcester, MA hospitals that publish prices. What you pay depends on the facility, your insurance, and whether you have met your deductible.
Where is the cheapest place to get a cataract surgery in Worcester, MA?
Based on declared prices, the lowest-cost facility in our Worcester, MA data is ATHOL MEMORIAL HOSPITAL INCORPORATED in Athol at about $1,061. Freestanding ambulatory surgery centers are often cheaper still and may not appear in hospital price data - ask your doctor whether one is an option.
Why is a cataract surgery so much cheaper at some Worcester, MA hospitals?
Prices vary up to 20.5× because each hospital sets its own list price, cash discount, and insurer-negotiated rates. In Worcester, MA, the median cash (self-pay) price is $9,170 versus a median negotiated rate of $8,240 - about 1.1× higher. Asking for the cash price as well as your insurer's negotiated rate is often the single biggest lever on what you pay.
How much will I actually pay out of pocket for a cataract surgery in Worcester, MA?
Your out-of-pocket cost depends on your deductible, coinsurance, out-of-pocket maximum, and whether the facility is in-network - not just the sticker price. If you have not met your deductible, you will typically pay the negotiated rate in full until you do. Use the CostKits cost forecaster to estimate your specific out-of-pocket amount before you go.
Before you book
- How to read your medical bill
- How to stop medical bill problems before they start
- How to negotiate your medical bills
- Allowed amount vs negotiated rate: what your EOB is really saying
- Understanding your UnitedHealthcare EOB
Other procedures in Worcester, MA
Cataract Surgery, elsewhere
What matters before you schedule
ASC vs. hospital
Hospital outpatient departments typically charge 2-4x more than ambulatory surgery centers for the same cataract surgery - same outcome, very different bill. Call ahead and ask for a self-pay or cash quote at each setting you're considering.
What's on your bill
A cataract surgery involves multiple providers who bill separately - typically Facility Fee, Surgeon Professional Fee, Anesthesia. Check each line item against your Explanation of Benefits to catch billing errors.
Cost by type
Which type your doctor orders for this cataract surgery changes the billing code, and what you pay. For example: A recognized variation that can change the billing code and what you owe.
What to ask before you book
Get the CPT code from your doctor, confirm every provider involved (not just the facility) is in-network, ask for the cash-pay rate if you're uninsured or haven't met your deductible, and request a written estimate for cataract surgery before you schedule.
CostKits compiles hospital price transparency data to help families make informed decisions. Track and manage your healthcare costs (free account).
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About the Author
John Caruso, FSA, MAAA
Healthcare actuary with 20+ years of experience in insurance pricing, medical billing systems, and healthcare cost analytics.
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