CMS Price Transparency Data
Cataract surgery with lens implant
Facility: Mercy Hospital Springfield
Billing Code: 66984 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 66984
- Insurance Median: $2,109
- Cash Discount Price: $9,267
- vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Mercy Hospital Springfield is $2,109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $9,267. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.89x the Medicare baseline. Located in 2115 S. Fremont Ave, Springfield, MO.
Cash / Self-Pay
$9,267
Average discount available for prompt cash payment at this facility.
Insurance Median
$2,109
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: $9,267 (393%)
Insurance Median: $2,109 (89%)
Cash: $9,267 (393% of Medicare)
Ins. Median: $2,109 (89% 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 |
|---|---|---|
| Medicaid / KanCare | $363 - $2,916 | 15% |
| Blue Cross Blue Shield | $475 - $7,109 | 20% |
| Evolutions Health Care Contracted [320124] | $1,381 | 59% |
| Federal Medical Center Contracted [320127] | $1,494 | 63% |
| Benefit Management Contracted [320052] | $1,546 | 66% |
| Health Systems Inc Contracted [320174] | $1,546 | 66% |
| Insurance System Inc Contracted [320465] | $1,546 | 66% |
| Aetna | $2,026 - $2,031 | 86% |
| Centurion Of Missouri [20459] | $2,026 | 86% |
| Champva [20065] | $2,026 | 86% |
| Cherokee Nation Health Serv Contracted [320066] | $2,026 | 86% |
| Cigna | $2,026 | 86% |
| Cross Timbers Hospice [20098] | $2,026 | 86% |
| Dept Of Veteran Affairs Contracted [320106] | $2,026 | 86% |
| Elara Caring Aspire Hospice [20433] | $2,026 | 86% |
| Globalhealth Contracted [320145] | $2,026 | 86% |
| Halo Hcr Inc Hospice Contracted [320432] | $2,026 | 86% |
| Halo Hcr Inc Hospice [20432] | $2,026 | 86% |
| Humana | $2,026 - $4,142 | 86% |
| Indian Health Service Contracted [320198] | $2,026 | 86% |
| Indian Health Service [20198] | $2,026 | 86% |
| Kindful Hospice Contracted [320434] | $2,026 | 86% |
| Kindful Hospice [20434] | $2,026 | 86% |
| Medicare (plans) | $2,026 - $2,130 | 86% |
| Mercy Hospice Okc [20252] | $2,026 | 86% |
| Mercy Mgd Behavioral Health Contracted [320259] | $2,026 | 86% |
| Mercy Rehab Hospital Contracted [320260] | $2,026 | 86% |
| Pace Of The Ozarks Contracted [320518] | $2,026 | 86% |
| Qual Choice Contracted [320325] | $2,026 | 86% |
| Tricare | $2,026 | 86% |
| UnitedHealthcare | $2,026 - $3,305 | 86% |
| Point C Contracted [320238] | $2,045 - $3,000 | 87% |
| Aither Health Contracted [320449] | $2,200 | 93% |
| Auxiant Contracted [320462] | $2,200 | 93% |
| Ebms Contracted [320493] | $2,200 | 93% |
| Edison Health Solutions Contracted [320502] | $2,200 | 93% |
| Healthlink Contracted [320179] | $2,200 | 93% |
| Imagine 360 Contracted [320494] | $2,200 | 93% |
| Mercy Benefit Admin Contracted [320251] | $2,200 - $3,037 | 93% |
| Reflect Health Contracted [320492] | $2,200 | 93% |
| Yuzu Health Contracted [320521] | $2,200 | 93% |
| Provider Partners Health Plans Contracted [320450] | $2,233 | 95% |
| Healthscope Contracted [320182] | $2,582 | 110% |
| Point C [20238] | $2,747 | 117% |
| 90 Degree Benefits Contracted [320436] | $2,899 | 123% |
| Show-Me Health Administrators Contracted [320483] | $2,899 - $3,037 | 123% |
| Centivo Contracted [320505] | $3,408 | 145% |
| Providrs Care Network Contracted [320484] | $4,219 | 179% |
| United Medical Resources Contracted [320454] | $4,695 | 199% |