Pterygium removal (eye) Cost by Hospital

Pterygium removal (eye) is a surgical procedure. Prices are from 1026 US hospitals across 50 states, from their machine-readable files.

$2,721median cash price · 1026 hospitals, 50 statestypically $661–$7,118 depending on the hospital
≈ 5.0× Medicare · High vs MedicareFind hospitals near you

Price comparison (median)

Chargemaster (list price)
$4,578
Cash / self-pay
$2,721
Insurer-negotiated
$2,425
Medicare pays
$540
$661$7,118
Median cash $2,721  ·  Medicare $540  ·  bar = typical cash range (10th–90th percentile)
Is this a fair price?
1× Medicarefair ≈2×5×+

Typical cash price here is $2,721 — about 5.0× the Medicare rate ($540). High vs Medicare. A fair cash price is usually within ~2× Medicare ($1,081).

💡 Asking for the cash price instead of the $4,578 list price could save about $1,857 (41%).

Estimate what you’ll pay
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Rough estimate from this procedure’s median insurer-negotiated rate. Your actual cost depends on your plan — confirm with your insurer.

Lowest cash prices

HospitalLocationCashInsurerCMS ratingER waitReadmit
Red Bud Regional Hospital Red Bud, IL $447 $767 ★ 4/5 122 min —
Deaconess Hospital Inc Evansville, IN $447 $493 ★ 2/5 186 min —
The Women's Hospital Newburgh, IN $447 $517 ★ 5/5 130 min —
Deaconess Henderson Hospital Henderson, KY $447 $660 ★ 2/5 127 min —
Beloit Health System Beloit, WI $476 $908 ★ 3/5 129 min —
Bayside Community Hospital Anahuac, TX $527 $304 — 106 min —
Truman Medical Center Hospital Hill Kansas City, MO $541 $1,040 ★ 3/5 224 min —
Vanderbilt Bedford Hospital Shelbyville, TN $551 $694 ★ 4/5 125 min —
Vanderbilt Tullahoma-Harton Hospital Tullahoma, TN $551 $694 ★ 3/5 168 min —
Children's Mercy South Overland Park, KS $560 $682 — — —
The Children's Mercy Hospital Kansas City, MO $560 $682 — — —
Grand River Hospital District Rifle, CO $596 $2,114 — 110 min —
Henderson County Community Hospital Lexington, TN $597 — — 151 min —
Citizens Memorial Hospital Bolivar, MO $604 $2,538 ★ 3/5 186 min —
University of Illinois Hospital and Clinics Chicago, IL $647 $511 ★ 4/5 298 min —
Ochsner Laird Hospital Union, MS $650 $383 — 102 min —
Ochsner Scott Regional Morton, MS $672 $383 — 82 min —
Ochsner Watkins Hospital Quitman, MS $714 $383 — 90 min —
Hurley Medical Center Flint, MI $728 $273 ★ 2/5 190 min —
Contra Costa Regional Medical Center Martinez, CA $729 — ★ 4/5 171 min —
Ochsner Stennis Memorial Hospital De Kalb, MS $736 $383 — 90 min —
Memorial Hermann Surgical Hospital Kingwood Kingwood, TX $781 $3,112 — — —
Southwestern Vermont Medical Center Bennington, VT $783 — ★ 3/5 202 min —
Washington Regional Medical Center Fayetteville, AR $798 — ★ 4/5 222 min —
Desoto Regional Health System Mansfield, LA $809 $1,155 ★ 2/5 109 min —

CMS rating = overall hospital star rating (1–5); ER wait = median minutes in the emergency department; Readmit = 30-day readmission rate (lower is better) — all from Medicare’s Care Compare; “—” = not reported. Data last updated October 2026. Prices from hospitals’ machine-readable files (45 CFR §180); Medicare benchmark from CMS PFS/CLFS/IPPS. Prices below 15% of the median are excluded as likely partial or mis-coded charges. Estimates — confirm with the hospital. Report an incorrect price.

What insurers pay for Pterygium removal (eye)

Median in-network negotiated rate by insurer, across hospitals that publish it (cheapest first). Your actual rate depends on your specific plan and deductible. Cash / self-pay for comparison: $2,721; Medicare pays $540.

InsurerHospitalsNegotiated median
Univera 7
$247
$39 – $405
Geisinger 21
$282
$255 – $2,748
AmeriHealth 100
$483
$185 – $8,727
Priority Health 11
$662
$242 – $2,392
Medicaid 69
$714
$299 – $2,150
Amerigroup 104
$733
$698 – $2,385
Sanford Health Plan 22
$1,172
$359 – $4,131
Bright Health 35
$1,187
$870 – $3,105
Highmark 39
$1,497
$427 – $5,063
Centene / Ambetter 382
$1,622
$493 – $5,360
Harvard Pilgrim 11
$1,708
$599 – $4,403
Medica 42
$1,741
$386 – $3,675
HealthPartners 60
$1,855
$386 – $4,200
Tricare / VA 89
$2,142
$372 – $3,842
Molina Healthcare 295
$2,191
$350 – $3,242
Coventry 27
$2,205
$415 – $3,849
Devoted Health 93
$2,310
$860 – $2,550
Security Health Plan 18
$2,316
$359 – $9,443
UCare 30
$2,335
$324 – $4,129
Medicare 139
$2,357
$370 – $3,260
Independent Health 8
$2,363
$1,965 – $2,761
UPMC Health Plan 29
$2,375
$410 – $6,431
Humana 460
$2,443
$419 – $4,690
Aetna 585
$2,496
$599 – $5,704
MVP Health Care 24
$2,761
$288 – $7,321
Kaiser Permanente 100
$2,819
$436 – $8,301
Anthem 266
$2,864
$443 – $7,485
Health Net 69
$2,964
$389 – $7,608
MultiPlan / PHCS network 145
$3,149
$677 – $5,695
Blue Cross Blue Shield 537
$3,309
$671 – $7,080
Cigna 494
$3,433
$1,534 – $10,835
Workers' Comp / No-Fault 19
$3,596
$339 – $3,596
UnitedHealthcare 670
$3,599
$504 – $8,834
Healthcare Highways 32
$3,650
$3,041 – $5,524
SelectHealth 27
$4,128
$1,213 – $5,307
EmblemHealth 37
$4,141
$424 – $18,756
Oscar Health 127
$5,571
$2,382 – $7,923
AvMed 28
$8,253
$4,185 – $12,418

Negotiated rates are from hospitals’ machine-readable files (45 CFR §180); payer names are normalized to major brands, so a brand may span several plans. Estimates — confirm with your insurer.

Where it’s cheapest

StateMedian cash
Puerto Rico$360
Kentucky$447
Indiana$447
Missouri$604
Mississippi$714
Michigan$728

Prices by city

Chicago, ILAustin, TXHouston, TXNew York, NYCharlotte, NCCleveland, OHDallas, TXFort Worth, TXLos Angeles, CASan Antonio, TXArlington, TXBronx, NYNashville, TNSacramento, CAAurora, COBrooklyn, NYColorado Springs, COKansas City, MOKnoxville, TNMilwaukee, WIPhiladelphia, PAPlano, TXSan Francisco, CATacoma, WA

Prices by state

TexasCaliforniaFloridaOhioIllinoisWisconsinNew YorkColoradoMinnesotaTennesseeLouisianaNorth CarolinaPennsylvaniaNew JerseyIndianaMaineMichiganWashingtonIowaSouth CarolinaOklahomaKansasGeorgiaVirginiaMissouriKentuckyNebraskaIdahoUtahArizonaAlabamaNew HampshireArkansasMassachusettsNevadaMississippiWest VirginiaMontanaPuerto RicoSouth DakotaNorth DakotaWyomingNew MexicoConnecticut

Does Medicare cover Pterygium removal (eye)?

Yes — Medicare generally covers Pterygium removal (eye). It is typically an outpatient service under Medicare Part B, with a Medicare-approved amount of about $540. After your annual Part B deductible, you typically owe the 20% coinsurance — roughly $108 — unless a Medicare Advantage or supplemental (Medigap) plan covers it.

General guidance from Medicare’s national rates — your actual coverage and share depend on medical necessity, your plan, and where the service is performed. Confirm with Medicare or your plan.

About these prices

Based on prices published by 1026 US hospitals across 50 states, the typical (median) cash price is $2,721, versus a chargemaster (list) price around $4,578, a median insurer-negotiated rate of $2,425, a Medicare rate of about $540. Most cash prices fall between $661 and $7,118 — a wide spread, which is exactly why comparing hospitals pays off.

How to save

  • Ask each hospital for its cash / self-pay price — for shoppable services it is often far below the list price.
  • Compare several nearby hospitals; prices for the same service can differ severalfold.
  • Request a written estimate and the billing code (CPT/DRG) before scheduling.
  • Use the Medicare benchmark above to judge whether a quote is reasonable.
  • If you are uninsured, ask about financial assistance or prompt-pay discounts.

Frequently asked questions

How much does Pterygium removal (eye) cost without insurance?
The median cash (self-pay) price across 1026 US hospitals is $2,721. Most hospitals fall between $661 and $7,118. Prices vary widely between hospitals, so it pays to compare before you book.
Does Medicare cover Pterygium removal (eye)?
Yes — it is generally covered under Medicare Part B as an outpatient service (Medicare-approved amount about $540). After your Part B deductible you typically owe 20% coinsurance, unless a Medicare Advantage or Medigap plan covers it.
What does Medicare pay for Pterygium removal (eye)?
Medicare pays about $540. We show this as a benchmark — a fair cash price is often within a few multiples of the Medicare rate.
Why do Pterygium removal (eye) prices vary between hospitals?
Hospitals set their own chargemaster and cash prices and negotiate different rates with each insurer, so two hospitals in the same area can charge very differently for the same service.
Is the cash price lower than using insurance?
Sometimes. If you are uninsured or have a high deductible, the cash/self-pay price can be lower than the insurer-negotiated rate — ask the hospital for both.

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