CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Presence Mercy Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 66984
  • Insurance Median: $2,461
  • Cash Discount Price: $2,460
  • vs. Medicare Baseline: 1.04x Medicare
The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Presence Mercy Medical Center is $2,461. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,460. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.04x the Medicare baseline. Located in 1325 N Highland Avenue, Aurora, IL.
Cash / Self-Pay
$2,460

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,461

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: $2,460 (104%)
Insurance Median: $2,461 (104%)
Cash: $2,460 (104% of Medicare)
Ins. Median: $2,461 (104% 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
Ravenswood Physicians Associates Ipa $484 - $2,461 21%
Resurrection Physicians Provider Group Ipa $484 - $2,461 21%
Cigna $1,065 - $4,550 45%
Standard Eapg Logic - Contracts $2,142 91%
Aetna $2,143 - $4,875 91%
Blue Cross Blue Shield $2,143 - $3,445 91%
Humana $2,143 - $2,707 91%
Medicaid / KanCare $2,143 - $2,250 91%
Harmony Health Plan $2,250 - $2,609 95%
Meridian $2,250 - $2,584 95%
Molina $2,250 - $3,691 95%
Advocate Helath Partners $2,461 - $2,707 104%
Celtic (Wellcare) $2,461 104%
Clear Spring Health Of Illinois $2,461 104%
Devoted Health $2,461 104%
Essential Health Partners $2,461 - $2,830 104%
Health Alliance Medical Plan $2,461 104%
Longevity Health Plan Of Illinois $2,461 104%
Medicare (plans) $2,461 104%
Self-Pay $2,461 104%
Tricare $2,461 104%
United Behavioral Health $2,461 104%
UnitedHealthcare $2,461 - $5,441 104%
Zing Health Provider Network $2,535 108%
Provider Partners Health Plan (Pphp) $2,584 110%
Access Community Health Network $2,953 125%
Clifton Health Systems $3,815 162%
Ambetter / Centene $3,987 169%
Imagine Health Network, Inc. $4,300 182%
Hfn Inc (Healthcare Finest Network) $6,782 288%
Corvel $6,928 294%
Coventry $6,928 294%
Workers Comp $6,928 294%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1325 N Highland Avenue, Aurora, IL 60506
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals