CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Mercyone Clinton Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $2,358
Cash Discount Price: $11,667
vs. Medicare Baseline: 1.00x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Mercyone Clinton Medical Center is $2,358. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $11,667. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.00x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.

Cash / Self-Pay

$11,667

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: $11,667 (495%)

Insurance Median: $2,358 (100%)

Cash: $11,667 (495% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Iowa Total Care	$2,125	90%
Medicaid / KanCare	$2,146 - $2,154	91%
Bcn Domestic	$2,358	100%
Blue Benefit Administrators Of Massachusetts	$2,358	100%
Blue Care Network	$2,358	100%
Blue Cross Blue Shield	$2,358 - $2,432	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%
Kaiser Domestic	$2,358	100%
Pre-Employment	$2,358	100%
Wc Domestic	$2,358	100%
Aetna	$2,408	102%
Medicare (plans)	$2,408 - $2,506	102%
UnitedHealthcare	$2,456	104%
Amish Hospital Aid	$3,268	139%
Oscar	$3,352	142%
Ambetter / Centene	$4,128	175%
Claimdoc	$4,939	209%
Nova	$4,939	209%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $11,667.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 66984.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercyone Clinton Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 66984.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.