CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Mercy Hospital Aurora

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $2,426
Cash Discount Price: $6,382
vs. Medicare Baseline: 1.03x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Mercy Hospital Aurora is $2,426. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $6,382. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.03x the Medicare baseline. Located in 500 Porter Avenue, Aurora, MO.

Cash / Self-Pay

$6,382

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,426

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: $6,382 (271%)

Insurance Median: $2,426 (103%)

Cash: $6,382 (271% of Medicare)

Ins. Median: $2,426 (103% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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 - $2,831	15%
Health Systems Inc Contracted [320174]	$1,546	66%
Insurance System Inc Contracted [320465]	$1,546	66%
Point C Contracted [320238]	$1,929	82%
Point C [20238]	$1,929	82%
Medicare (plans)	$2,130	90%
Blue Cross Blue Shield	$2,994 - $25,348	127%
UnitedHealthcare	$2,994	127%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $6,382.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 66984.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercy Hospital Aurora is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 66984.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.