CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Mercy Hospital St Louis

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 66984
  • Insurance Median: $3,087
  • Cash Discount Price: $5,266
  • vs. Medicare Baseline: 1.31x Medicare
The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Mercy Hospital St Louis is $3,087. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,266. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.31x the Medicare baseline. Located in 615 New Ballas Road, Saint Louis, MO.
Cash / Self-Pay
$5,266

Average discount available for prompt cash payment at this facility.

Insurance Median
$3,087

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$2,357.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $2,357.81 (100%)
Cash / Self-Pay: $5,266 (223%)
Insurance Median: $3,087 (131%)
Cash: $5,266 (223% of Medicare)
Ins. Median: $3,087 (131% of 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $499 - $7,801 21%
Indian Health Service Contracted [320198] $499 21%
Mercy Benefit Admin Contracted [320251] $1,400 - $3,234 59%
Mercy Benefit Admin [20251] $1,400 - $3,234 59%
Medicaid / KanCare $1,944 - $3,033 82%
Aetna $2,119 90%
American Health Advantage Of Mo Mcr [10473] $2,119 90%
Cherokee Nation Health Serv Contracted [320066] $2,119 90%
Cross Timbers Hospice [20098] $2,119 90%
Dept Of Veteran Affairs Contracted [320106] $2,119 90%
Elara Caring Aspire Hospice Contracted [320433] $2,119 90%
Elara Caring Aspire Hospice [20433] $2,119 90%
Globalhealth Contracted [320145] $2,119 90%
Halo Hcr Inc Hospice Contracted [320432] $2,119 90%
Halo Hcr Inc Hospice [20432] $2,119 90%
Humana $2,119 90%
Kindful Hospice Contracted [320434] $2,119 90%
Kindful Hospice [20434] $2,119 90%
Medicare (plans) $2,119 - $2,204 90%
Mercy Hospice Okc [20252] $2,119 90%
Pace Of The Ozarks Contracted [320518] $2,119 90%
Qual Choice Contracted [320325] $2,119 90%
Tricare $2,119 90%
UnitedHealthcare $2,119 - $2,528 90%
Hope Trust Contracted [320488] $2,160 92%
Cigna $2,162 92%
Provider Partners Health Plans Contracted [320450] $2,335 99%
Medica Contracted [320239] $2,553 108%
Healthscope Contracted [320182] $2,700 115%
Show-Me Health Administrators Contracted [320483] $3,140 - $3,297 133%
Aither Health Contracted [320449] $3,234 137%
Aither Health [20449] $3,234 137%
Auxiant Contracted [320462] $3,234 137%
Ebms Contracted [320493] $3,234 137%
Edison Health Solutions Contracted [320502] $3,234 137%
Healthlink Contracted [320179] $3,234 137%
Imagine 360 Contracted [320494] $3,234 137%
Reflect Health Contracted [320492] $3,234 137%
Yuzu Health Contracted [320521] $3,234 137%
Centivo Contracted [320505] $3,565 151%
Preferred Health Plan Contracted [320522] $3,781 160%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 615 New Ballas Road, Saint Louis, MO 63141
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals