Cataract surgery with lens implant
Facility: Pratt Regional Medical Center
Billing Code: 66984 (CPT)
- CPT Billing Code: 66984
- Insurance Median: $3,674
- Cash Discount Price: $3,091
- vs. Medicare Baseline: 1.56x 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 |
|---|---|---|
| Celtic Insurance Company | $2,160 | 92% |
| Healthy Blue | $2,225 | 94% |
| UnitedHealthcare | $2,376 - $4,504 | 101% |
| Christian Health Aid | $3,312 | 140% |
| Health Partners Of Kansas | $3,754 | 159% |
| Aetna | $3,974 | 169% |
| Choicecare | $4,416 | 187% |
Consumer Guidance & Cost Commentary
For cataract surgery with lens implant at Pratt Regional Medical Center in Pratt, KS, the facility's cash median price of $3,091 is notably lower than the negotiated rates charged by major insurers like UnitedHealthcare, which range from $2,376 to $4,504 depending on the plan. While the facility's gross charge is $4,416, patients with high-deductible plans may find paying out-of-pocket at the cash rate more cost-effective than relying on insurance, which often results in higher allowed amounts due to administrative overhead and contract dynamics. It is important to verify "self-pay" or "prompt-pay" discounts directly with the hospital before scheduling, as these upfront payment incentives can significantly reduce the final bill by bypassing costly claims processing and administrative fees.
When evaluating this price against national standards, the facility's cash rate is approximately 1.6 times the Medicare benchmark of $2,357.81, which serves as a scientifically validated baseline for the true cost of care. Although the data does not provide specific state or county average comparisons for this procedure, the wide variation in negotiated rates among payers—such as Celtic Insurance Company's fixed rate of $2,160 versus Aetna's $3,974—highlights that in-network status does not guarantee the lowest possible price. Consumers should request a full itemized CPT-coded bill to ensure no errors, unbundled charges, or services not rendered are included, as over 80% of hospital bills contain discrepancies that can be resolved through formal written audits rather than verbal disputes.