Cataract surgery with lens implant
Facility: Phillips County Hospital
Billing Code: 66984 (CPT)
- CPT Billing Code: 66984
- Insurance Median: $4,192
- Cash Discount Price: $3,937
- vs. Medicare Baseline: 1.78x 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 |
|---|---|---|
| Blue Cross Blue Shield | $2,861 - $3,752 | 121% |
| UnitedHealthcare | $3,706 - $4,632 | 157% |
| Medicaid / KanCare | $4,632 | 196% |
| Health Partners-All Plans | $4,632 | 196% |
Consumer Guidance & Cost Commentary
For cataract surgery with lens implant at Phillips County Hospital in Phillipsburg, KS, the facility's cash median price is $3,937, which is lower than the negotiated rates paid by major payers like UnitedHealthcare ($4,632) and Blue Cross Blue Shield ($3,706 to $4,632). While Medicaid/KanCare and Health Partners-All Plans cover the full gross charge of $4,632, patients with high-deductible plans may find paying cash directly more cost-effective if their insurance negotiated rate exceeds the cash price. It is important to note that this facility is a Critical Access Hospital with government-local ownership, and patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling to potentially reduce the final bill further.
The facility's gross charge of $4,632 is significantly higher than the Medicare benchmark of $2,357.81, reflecting a markup common in commercial billing where administrative costs and contract structures inflate the baseline price. Although the data does not provide specific county or state average comparisons for this procedure, the substantial difference between the Medicare rate and the facility's gross charge highlights the importance of understanding that commercial rates often exceed the federal "true cost" of care. To avoid unexpected balance billing or errors, patients should request an itemized CPT-coded bill to review every charge, ensuring no unbundled services or cancelled tests are included, and should dispute any discrepancies in writing rather than accepting summary invoices.