Cataract surgery with lens implant
Facility: Cheyenne County Hospital
Billing Code: 66984 (CPT)
- CPT Billing Code: 66984
- Insurance Median: $4,272
- Cash Discount Price: $3,822
- vs. Medicare Baseline: 1.81x 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 | $1,490 - $4,497 | 63% |
| Blue Cross Blue Shield | $2,679 | 114% |
| First Health - All Plans | $3,148 | 134% |
| Tricare | $3,238 | 137% |
| Healthy Blue Mcr Adv | $3,238 | 137% |
| Aetna | $3,238 - $4,272 | 137% |
| Choice Care - All Plans | $3,270 | 139% |
| Firstguard - All Plans | $3,598 | 153% |
| Wppa - All Plans | $4,047 | 172% |
| Cpm - All Plans | $4,272 | 181% |
| Preferred Hc - All Plans | $4,272 | 181% |
| Midlands Choice - All Plans | $4,362 | 185% |
| Integrated Hp - All Plans | $4,407 | 187% |
| Ppo Next - All Plans | $4,407 | 187% |
| Unicare - All Plans | $4,407 | 187% |
| Health Partners - All Plans | $4,407 | 187% |
| Childrens Mercy - All Plans | $4,497 | 191% |
| Healthy Blue Mcaid - All Other Plans | $4,497 | 191% |
| Healthwave Mcaid - All Plans | $4,497 | 191% |
| Providers Care-All Plans | $6,746 | 286% |
Consumer Guidance & Cost Commentary
For CPT code 66984, cataract surgery with lens implant, Cheyenne County Hospital in St. Francis, KS, lists a gross charge of $4,497.00. This amount is significantly higher than the facility's cash median of $3,822.00 and the state average negotiated rate of $4,272.00. While the facility is a Critical Access Hospital, patients should be aware that cash payments can sometimes be more cost-effective than insurance claims, particularly for those with high-deductible plans where the insurer's negotiated rate might exceed the cash price. To minimize out-of-pocket costs, patients are encouraged to contact the hospital directly to inquire about self-pay discounts or prompt-pay incentives before scheduling the procedure.
The data indicates that Medicare reimbursement for this service is $2,357.81, which serves as a key benchmark for evaluating commercial pricing. Commercial negotiated rates across various payers range from $2,679 to $6,746, with the median negotiated amount at $4,272.00. It is important to note that commercial rates often include administrative overhead and do not reflect the true cost of care, which is better represented by the Medicare rate. Patients should avoid accepting summary bills and instead request a detailed, itemized statement to identify any unbundled codes or services not rendered. If a balance bill arises from an out-of-network situation, patients may be eligible for protections under the No Surprises Act, which limits billing for emergency care and non-emergency services at in-network facilities.