Cataract surgery with lens implant
Facility: Morris County Hospital
Billing Code: 66984 (CPT)
- CPT Billing Code: 66984
- Insurance Median: $2,789
- Cash Discount Price: $3,306
- vs. Medicare Baseline: 1.18x 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 |
|---|---|---|
| Providrs Care (Wppa)(Nexus)-All Plans | $1,124 | 48% |
| Coventry Mcr | $2,149 | 91% |
| UnitedHealthcare | $2,149 - $5,510 | 91% |
| Choice Care Mcr Adv-All Plans | $2,149 | 91% |
| Va Ccn-All Plans | $2,149 | 91% |
| Blue Cross Blue Shield | $2,149 - $2,861 | 91% |
| Cigna | $3,986 | 169% |
| Aetna | $4,937 | 209% |
| Multiplan-All Plans | $4,959 | 210% |
| Coventry Comm-All Other Plans | $4,959 | 210% |
Consumer Guidance & Cost Commentary
For patients seeking cataract surgery with lens implant at Morris County Hospital in Council Grove, KS, the financial landscape varies significantly depending on payment method. While the facility's cash median price is $3,306, the negotiated rates paid by insurance plans range from a low of $1,124 to a high of $5,510, with most commercial payers settling around $2,149 to $2,861. This data suggests that for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying cash upfront could result in lower total costs compared to the insurance negotiated rate, provided the patient qualifies for the facility's prompt-pay discount. It is crucial to verify "self-pay" or "prompt-pay" rates directly with the hospital before scheduling, as these discounts can reduce the bill by 20% to 50% if paid in full within a short window, bypassing the administrative overhead and collection fees associated with insurance claims.
The facility's pricing structure is evaluated against federal benchmarks to ensure transparency. The Medicare amount for this procedure is $2,357.81, which serves as the objective baseline for fair pricing. The facility's cash median of $3,306 represents a markup of approximately 1.2 times the Medicare rate, while the median negotiated rate of $2,789 falls within the typical range of 120% to 150% of Medicare, indicating a relatively fair commercial rate. Although the facility is a Critical Access Hospital with government-local ownership, patients should remain vigilant regarding balance billing protections under the No Surprises Act, which prevents unexpected charges for out-of-network