Cataract surgery with lens implant
Facility: Susan B Allen Memorial Hospital
Billing Code: 66984 (CPT)
- CPT Billing Code: 66984
- Insurance Median: $554
- Cash Discount Price: $1,992
- vs. Medicare Baseline: 0.23x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. 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.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| UnitedHealthcare | $350 | 15% |
| Providrs Care | $757 | 32% |
Consumer Guidance & Cost Commentary
For cataract surgery with lens implant at Susan B Allen Memorial Hospital in El Dorado, KS, the facility's cash median price is $1,992.00, which is lower than the Medicare benchmark of $2,357.81. While the hospital offers a negotiated rate of $554.00 for in-network payers like UnitedHealthcare and Providrs Care, patients should be aware that commercial negotiated rates often exceed cash prices due to administrative overhead and contract structures. If you have a high-deductible plan where your out-of-pocket costs are expected to be high, paying the cash price directly might result in lower total costs compared to having your insurance process a claim that exceeds the cash rate. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available before scheduling your appointment.
This procedure carries a gross charge of $3,065.00, and while specific county or state average comparisons are not provided in the current data, the Medicare benchmark serves as a reliable baseline for evaluating pricing fairness. Under the No Surprises Act, you are protected from balance billing for out-of-network providers at in-network facilities, though you should still request an itemized bill to ensure no unbundled codes or services not rendered are included. If you receive a bill that appears inflated, you have the right to dispute it in writing with the billing supervisor rather than accepting a summary invoice. Always verify your deductible status before proceeding, as paying the negotiated rate may not be cost-effective if you have not yet met your annual out-of-pocket maximum.