CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Wesley Medical Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 66984
  • Insurance Median: $2,856
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.21x Medicare
The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Wesley Medical Center is $2,856. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.21x the Medicare baseline. Located in 550 N Hillside Street, Wichita, KS.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$2,856

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%)
Insurance Median: $2,856 (121%)
Ins. Median: $2,856 (121% 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
UnitedHealthcare $755 32%
Medicaid / KanCare $778 33%
Aetna $785 - $4,878 33%
Amerigroup $785 33%
Usa Managed Care $1,584 67%
Blue Cross Blue Shield $2,543 108%
First Health $3,650 155%
Multiplan $3,803 161%
United $4,423 188%

Consumer Guidance & Cost Commentary

For patients at Wesley Medical Center in Wichita, KS, the negotiated rates for cataract surgery with lens implant vary significantly depending on the insurance carrier, ranging from $755 for UnitedHealthcare and Medicaid/KanCare up to $4,423 for United. While the median negotiated rate across all payers is $2,856, the facility's cash price is not listed in this report. It is important to note that cash-pay options can sometimes be more affordable for individuals with high-deductible plans if their insurance negotiated rate exceeds the cash price, though the specific cash rate here is unavailable. Patients should proactively ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce costs by 20% to 50% by bypassing administrative claim processing fees.

This procedure's pricing is benchmarked against the national standard, with the facility's allowed amount being 120% higher than the Medicare rate of $2,357.81. While the data does not provide specific Kansas or county average comparisons for this code, the wide variance in negotiated rates among the nine payers highlights the importance of verifying your specific plan's allowed amount prior to treatment. To ensure you are not overcharged, we recommend requesting a full itemized bill that lists every CPT code and service rendered, as summary bills often obscure errors or unbundled charges. If you receive a balance bill for out-of-network services, you may be entitled to protections under the No Surprises Act, which prevents providers from charging you the difference between their full rate and your insurance's allowed amount.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 550 N Hillside Street, Wichita, KS 67214
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals