CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Mercy St Francis Hospital

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 66984
Insurance Median: $2,994
Cash Discount Price: $5,655
vs. Medicare Baseline: 1.27x Medicare

The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Mercy St Francis Hospital is $2,994. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $5,655. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 1.27x the Medicare baseline. Located in 100 West Highway 60, Po Box 82, Mountain View, MO.

Cash / Self-Pay

$5,655

Average discount available for prompt cash payment at this facility.

Insurance Median

$2,994

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: $5,655 (240%)

Insurance Median: $2,994 (127%)

Cash: $5,655 (240% of Medicare)

Ins. Median: $2,994 (127% 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	$755 - $2,994	32%
Multiplan Contracted [320270]	$1,000	42%
Private Health Care Systems Contracted [320320]	$1,000	42%
UnitedHealthcare	$1,000 - $2,994	42%
Medicare (plans)	$2,130	90%
Blue Cross Blue Shield	$2,139 - $24,625	91%

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 $5,655.
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 St Francis Hospital 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.