Cataract surgery with lens implant
Facility: Kansas City Orthopaedic Institute
Billing Code: 66984 (CPT)
- CPT Billing Code: 66984
- Insurance Median: $5,377
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 2.28x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 228% of the Medicare baseline (a markup of 128%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 | $2,068 | 88% |
| Aetna | $2,068 | 88% |
| Cigna | $2,146 | 91% |
| Blue Cross Blue Shield | $5,377 | 228% |
Consumer Guidance & Cost Commentary
For the CPT code 66984, representing cataract surgery with a lens implant, the facility in Leawood, Kansas, has a median negotiated rate of $5,377.00. This rate is significantly higher than the state average, which is reflected in the data where the highest negotiated amount among the four payers is $5,377.00, compared to the Medicare benchmark of $2,357.81. The facility's negotiated rates range from $2,068 to $5,377 depending on the specific insurance plan, with UnitedHealthcare and Aetna showing a low of $2,068 and Cigna at $2,146. While these negotiated rates are contractually agreed upon to protect in-network members, they often exceed the cash price, meaning patients with high-deductible plans might save money by paying cash directly if they can secure a self-pay or prompt-pay discount before scheduling.
To ensure you are getting the best possible price, it is important to verify that the facility is in-network and to check your specific deductible status before proceeding, as high negotiated rates may not apply if your plan has not yet met its out-of-pocket threshold. Since the facility is an Acute Care Hospital owned by a physician group, you should explicitly ask about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront. Additionally, because over 80% of hospital bills contain errors, you should request a detailed, itemized bill rather than accepting a summary invoice, and consider disputing any charges that do not