CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Kossuth Regional Health Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $4,336
Cash Discount Price: $4,570
vs. Medicare Baseline: 1.84x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Kossuth Regional Health Center is $4,336. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $4,570. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.84x the Medicare baseline. Located in 1515 South Phillips Street, Algona, IA.

Cash / Self-Pay

$4,570

Average discount available for prompt cash payment at this facility.

Insurance Median

$4,336

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: $4,570 (194%)

Insurance Median: $4,336 (184%)

Cash: $4,570 (194% of Medicare)

Ins. Median: $4,336 (184% 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
Blue Cross Blue Shield	$2,143 - $2,355	91%
Mercy One - All Plans	$2,171	92%
Va Ccn - All Plans	$2,171	92%
Humana	$2,193	93%
Amerigroup Mcr Adv - All Other Plans	$2,214	94%
UnitedHealthcare	$2,236 - $4,336	95%
Health Partners New Bus - All Other Plans	$3,999	170%
Midlands Choice - All Plans	$3,999	170%
Medical Associates - All Plans	$4,856	206%
Preferred Health - All Plans	$4,856	206%
Aetna	$5,313 - $5,542	225%
Multiplan - All Plans	$5,427	230%
Health Partners Exisiting Bus	$5,542	235%
Molina Mcaid/Chip - All Plans	$5,884	250%
Amerigroup Mcaid	$5,942	252%

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 $4,570.
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 Kossuth Regional Health 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.