Cataract surgery with lens implant
Facility: Fredonia Regional Hospital
Billing Code: 66984 (CPT)
- CPT Billing Code: 66984
- Insurance Median: $2,706
- Cash Discount Price: $3,121
- vs. Medicare Baseline: 1.15x 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 | $1,544 - $2,706 | 65% |
| Veterans Programs - All Plans | $1,592 | 68% |
| UnitedHealthcare | $1,592 - $2,809 | 68% |
| Aetna | $1,592 - $2,809 | 68% |
| Cigna | $2,809 | 119% |
| Meritain-All Plans | $2,809 | 119% |
| Reserve National-All Plans | $2,809 | 119% |
Consumer Guidance & Cost Commentary
For the CPT code 66984 (Cataract surgery with lens implant) at Fredonia Regional Hospital in Fredonia, KS, the cash price is $3,121.00, which matches the facility's median paid amount. This cash rate is notably higher than the state average for this procedure, as the median paid across Kansas is $1,744.00. While commercial insurance plans like Blue Cross Blue Shield, UnitedHealthcare, and Aetna have negotiated rates ranging from $1,544 to $2,809, these amounts often exceed the cash price. Patients with high-deductible plans may find it financially advantageous to pay the cash rate directly, as the insurance negotiated rate could be higher than the out-of-pocket cost. It is important to contact the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final bill.
The facility's billing practices align with standard industry benchmarks, where commercial negotiated rates typically range from 200% to 300% of the Medicare rate of $2,357.81 for this service. Although the hospital is a Critical Access Hospital owned by the local government, the cash price remains above the state median, suggesting that the facility's pricing structure differs from the broader Kansas average. Consumers should be aware that while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, it is still prudent to request an itemized bill to verify all charges. If any discrepancies arise, such as unbundled codes or services not rendered, a formal written audit dispute should be sent to the billing supervisor to ensure