Cataract surgery with lens implant
Facility: Community Memorial Healthcare, Inc.
Billing Code: 66984 (CPT)
- CPT Billing Code: 66984
- Insurance Median: $1,895
- Cash Discount Price: $3,102
- vs. Medicare Baseline: 0.80x 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 |
|---|---|---|
| Aetna | $1,427 - $2,016 | 61% |
| UnitedHealthcare | $1,774 | 75% |
| Blue Cross Blue Shield | $2,706 | 115% |
Consumer Guidance & Cost Commentary
For cataract surgery with lens implant at Community Memorial Healthcare, Inc. in Marysville, KS, the cash median price is $3,102, which matches the facility's gross charge. This rate is significantly higher than the state average for this procedure, as indicated by a Medicare benchmarking ratio of 0.8, suggesting the facility's pricing structure is well above the federal baseline. While the facility is a Critical Access Hospital with a voluntary non-profit ownership, patients should be aware that commercial insurance negotiated rates for this service range from $1,427 to $2,706 depending on the payer, with UnitedHealthcare and Blue Cross Blue Shield offering single-plan rates of $1,774 and $2,706 respectively. Although the cash price appears high, it is worth noting that for patients with high-deductible plans, paying out-of-pocket might be more cost-effective if the insurance company's allowed amount exceeds the cash price, though the data shows the median paid amount is $620, indicating substantial insurance coverage for most enrollees.
Patients should carefully review their specific plan details before scheduling, as the facility offers a median negotiated rate of $1,895, which serves as a ceiling for in-network coverage but does not reflect the final out-of-pocket cost for everyone. It is crucial to ask the hospital directly about "self-pay" or "prompt-pay" discounts before check-in, as these upfront payment incentives can reduce the total bill by 20% to 50% by bypassing costly insurance claims processing. If you receive a bill from this facility, always request a full itemized CPT-coded statement rather than accepting a summary bill,