CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Mercyone Newton Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 66984
  • Insurance Median: $2,358
  • Cash Discount Price: $7,795
  • vs. Medicare Baseline: 1.00x Medicare
The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Mercyone Newton Medical Center is $2,358. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $7,795. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.00x the Medicare baseline. Located in 204 N 4Th Ave E, Newton, IA.
Cash / Self-Pay
$7,795

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,358

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$2,357.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $2,357.81 (100%)
Cash / Self-Pay: $7,795 (331%)
Insurance Median: $2,358 (100%)
Cash: $7,795 (331% of Medicare)
Ins. Median: $2,358 (100% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $2,357.81 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Aetna $2,184 93%
Medicare (plans) $2,184 - $2,274 93%
Blue Cross Blue Shield $2,206 - $2,358 94%
UnitedHealthcare $2,228 94%
Blue Benefit Administrators Of Massachusetts $2,358 100%
Blue Care Network $2,358 100%
Blue Distinction Transplant $2,358 100%
Blue Shield - Ca $2,358 100%
Blue Shield - Id (Regence) $2,358 100%
Blue Shield - Ny Highmark Northeastern $2,358 100%
Blue Shield - Ny Highmark Western $2,358 100%
Blue Shield - Pa (Highmark) $2,358 100%
Blue Shield - Wa (Regence) $2,358 100%
Iowa Total Care $2,662 113%
Medicaid / KanCare $2,688 - $2,698 114%
Amish Hospital Aid $2,965 126%
Oscar $3,168 134%
Centivo $3,217 136%
Ambetter / Centene $3,745 159%
Claimdoc $4,480 190%
Nova $4,480 190%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 204 N 4Th Ave E, Newton, IA 50208
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals