Cataract Surgery Cost in Pennsylvania (2026): Average Prices & What You'll Pay
What does a cataract surgery cost in Pennsylvania?
Where you have a cataract surgery done in Pennsylvania swings the bill from $627 to $1,123 for identical care. The median cash price across 99 reporting hospitals is $834. The numbers are pulled directly from federally mandated hospital price transparency files. The sections below break this down by coverage and by insurer.
Three low-priced facilities in Pennsylvania, from hospital price files
- Monogahela Valley Hospital $517
- WEST PENN ALLEGHENY HEALTH SYSTEM INC · Wexford, PA $532
- UPMC St Margaret · Pittsburgh, PA $549
Free: the typical range and the facilities above. Add your email and we send the full ranked list of all 99 facilities (PDF) plus a checklist of what to ask before you book. We don't sell your information (privacy policy).
Where cataract surgery costs vary in Pennsylvania
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
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Cheapest Cataract Surgery Providers in Pennsylvania
Based on declared cash/self-pay prices from CMS hospital price transparency files.
| # | Facility | City | Price | vs Median |
|---|---|---|---|---|
| 1 | Hospital name hidden | Your City, PA | $916 | -$000 |
| 2 | Monogahela Valley Hospital | PA | $517 | -$317 |
| 3 | WEST PENN ALLEGHENY HEALTH SYSTEM INC | Wexford, PA | $532 | -$302 |
| 4 | Hospital name hidden | Your City, PA | $919 | -$000 |
| 5 | Hospital name hidden | Your City, PA | $920 | -$000 |
| 6 | UPMC St Margaret | Pittsburgh, PA | $549 | -$285 |
| 7 | Hospital name hidden | Your City, PA | $922 | -$000 |
| 8 | Hospital name hidden | Your City, PA | $923 | -$000 |
Your ranked price list is on its way to your email. Open the PDF now.
Prices are declared self-pay rates. Contact each facility for a formal quote before scheduling.
Email me this price comparison plus what to ask before booking
Sends a PDF with all 99 facilities ranked cheapest first, plus a short checklist of questions that change what you pay. We don't sell your information (privacy policy).
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
- UPMC Mercy is the lowest-cost option at $515 - $319 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 $834, and it's often lower than what insurance pays before your deductible is satisfied.
- Freestanding ambulatory surgical centers (ASCs) are often 30-60% cheaper than hospital outpatient departments for the same procedure and may not appear in this hospital-only dataset - ask your doctor if 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) | 78 | $877 to $7,006 | $2,500 |
| Without insurance (cash price) | 104 | $512 to $3,348 | $834 |
| Highmark Blue Cross Blue Shield | 73 | $777 to $6,541 | $2,676 |
| Aetna | 56 | $467 to $11,011 | $4,863 |
| Cigna | 53 | $837 to $9,095 | $2,402 |
| UnitedHealthcare | 47 | $884 to $7,055 | $1,370 |
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 Pennsylvania?
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 Pennsylvania?
Across 78 Pennsylvania hospitals, the negotiated rates commercial insurers pay for cataract surgery average $877 to $7,006 per hospital, with a median near $2,500. 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 Pennsylvania?
Cash (self-pay) prices for cataract surgery at 104 Pennsylvania hospitals range from $512 to $3,348, with a median of $834. 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 Highmark Blue Cross Blue Shield in Pennsylvania?
Highmark Blue Cross Blue Shield negotiated rates for cataract surgery at 73 Pennsylvania hospitals range from $777 to $6,541, with a median near $2,676. 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 Aetna in Pennsylvania?
Aetna negotiated rates for cataract surgery at 56 Pennsylvania hospitals range from $467 to $11,011, with a median near $4,863. If a hospital is out of network for your Aetna plan, you may owe more than the negotiated rate, so check the network first.
How much does a cataract surgery cost with Cigna in Pennsylvania?
Cigna negotiated rates for cataract surgery at 53 Pennsylvania hospitals range from $837 to $9,095, with a median near $2,402. If a hospital is out of network for your Cigna plan, you may owe more than the negotiated rate, so check the network first.
How much does a cataract surgery cost with UnitedHealthcare in Pennsylvania?
UnitedHealthcare negotiated rates for cataract surgery at 47 Pennsylvania hospitals range from $884 to $7,055, with a median near $1,370. 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 where you go changes what you pay for cataract surgery
The same cataract surgery bundles different services depending on the setting - facility fee, surgeon fee, and anesthesia each arrive as separate bills. Estimated ranges below reflect the typical full bundled cost, including all expected charges.
- Facility fee $502–$8,886
- Professional fee $803–$2,932
Estimated from CMS fee schedules + commercial rate multipliers
- Facility fee $502–$8,886
- Professional fee $803–$2,932
Estimated from CMS fee schedules + commercial rate multipliers
Pennsylvania has a highly fragmented hospital market - Penn Medicine, Jefferson Health, Temple Health, and Tower Health compete in Philadelphia; UPMC and Highmark/Allegheny Health Network are engaged in one of the country's most litigated payer-provider disputes in Pittsburgh. The UPMC vs. Highmark conflict has directly affected patients' ability to use their insurance at in-network facilities. Rural Pennsylvania prices are substantially lower than the two major metro markets. 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.
Received a bill? Check it for errors → Estimate YOUR cost before you go → Managing more than one bill? See the family tracker →
Why prices vary - and what it means for your coverage
A small number of hospitals (11) report prices above $3,020, including Edgewood Surgical Hopsital at $8,886, which drives most of the overall spread - excluding them, most facilities cluster in a much tighter band. Setting matters too: the median outpatient price is $834 versus $1,340 inpatient (about 1.6× more), so where a procedure happens often matters more than which hospital you pick. 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 | ~$834 |
| Deductible met - 20% coinsurance | ~$167 |
| Out-of-network provider | $1,835+ |
Frequently asked questions: cataract surgery costs in Pennsylvania
How much does a cataract surgery cost in Pennsylvania?
The typical insurer-negotiated rate is $485, with most facilities between $138 and $783 (based on 101 hospitals reporting negotiated rates). Full market pricing - including cash rates, gross charges, and outlier facilities - ranges more widely, from $300 to $24,495 across all 99 Pennsylvania 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 Pennsylvania?
Based on declared prices, the lowest-cost facility in our Pennsylvania data is Penn Highlands Huntingdon in Huntingdon at about $502. By metro, Pittsburgh has the lowest median ($552). 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 Pennsylvania hospitals?
Prices vary up to 81.7× because each hospital sets its own list price, cash discount, and insurer-negotiated rates. In Pennsylvania, the median cash (self-pay) price is $834 versus a median negotiated rate of $2,500 - cash is the lower number at many hospitals. 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 Pennsylvania?
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
- Deductible vs out-of-pocket max
- How to negotiate your medical bills
- EOB vs medical bill: complete guide
- Already have a bill? Check it for errors
- How to read a Medicare Summary Notice
Other procedures in Pennsylvania
Cataract Surgery, elsewhere
- Cataract Surgery costs across all states
- Cataract Surgery cost in Allentown, PA
- Cataract Surgery cost in Altoona, PA
- Cataract Surgery cost in Harrisburg, PA
- Cataract Surgery cost in Philadelphia, PA
- Cataract Surgery cost in Pittsburgh, PA
- Cataract Surgery cost in Reading, PA
- New Jersey
- New York
- Ohio
- Maryland
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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