Cataract surgery with lens implant
Facility: Children'S Mercy South
Billing Code: 66984 (CPT)
- CPT Billing Code: 66984
- Insurance Median: $1,149
- Cash Discount Price: $813
- vs. Medicare Baseline: 0.49x 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 | $520 - $1,191 | 22% |
| Healthy Blue | $554 - $1,103 | 23% |
| Medicaid / KanCare | $559 | 24% |
| Wppa Providrs Care | $637 | 27% |
| Healthlink | $655 | 28% |
| Health Midwest Comprehensive Care | $710 | 30% |
| American Healthcare Alliance | $758 | 32% |
| Quiktrip | $876 | 37% |
| Blue Cross Blue Shield | $939 - $1,216 | 40% |
| Wellfit/Centrus | $981 | 42% |
| Medica | $988 | 42% |
| Nebraska Furniture Mart | $1,010 | 43% |
| Centivo | $1,011 | 43% |
| Home State Health | $1,103 | 47% |
| Aetna | $1,117 - $1,325 | 47% |
| Humana | $1,157 | 49% |
| Orscheln | $1,170 | 50% |
| Multiplan | $1,175 | 50% |
| Mercy Health | $1,237 | 52% |
| Coxhealth Network | $1,254 | 53% |
| Cigna | $1,349 | 57% |
| Coventry Health Care Of Kansas | $1,412 | 60% |
| National Preferred Provider Network | $1,491 | 63% |
Consumer Guidance & Cost Commentary
For the CPT code 66984, representing cataract surgery with lens implant, the gross charge at Children's Mercy South in Overland Park is $1,694. This amount is significantly higher than the Medicare benchmark of $2,357.81, with a ratio of 0.5, indicating the facility's pricing structure relative to federal standards. While the facility offers a median negotiated rate of $1,149 across 23 payers, commercial insurance rates vary widely, ranging from a low of $520 with UnitedHealthcare to a high of $1,491 with National Preferred Provider Network. Patients should be aware that while in-network insurance provides a ceiling on costs, the actual amount paid depends heavily on individual plan deductibles and co-pays, which can sometimes result in higher out-of-pocket expenses than the cash price.
The cash price for this procedure is $813, which is notably lower than the median negotiated rate of $1,149. For patients with high-deductible plans who have not yet met their coverage thresholds, paying the cash price or utilizing a prompt-pay discount may be more financially advantageous than relying on insurance, as the insurer's negotiated rate often includes administrative overhead that exceeds the actual cost of care. It is important to verify the specific "self-pay" or "prompt-pay" discount rates directly with the hospital before scheduling, as these discounts can bypass the standard insurance billing cycle. Additionally, patients should request an itemized bill to ensure no errors exist, as over 80% of hospital bills contain discrepancies that can be resolved through a formal audit.