Cataract surgery with lens implant
Facility: Oakleaf Surgical Hospital
Billing Code: 66984 (CPT)
- CPT Billing Code: 66984
- Insurance Median: $2,286
- Cash Discount Price: $641
- vs. Medicare Baseline: 0.97x 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 |
|---|---|---|
| Blue Cross Blue Shield | $2,286 - $5,342 | 97% |
| Dean Health Plan | $2,286 | 97% |
| Group Health Cooperative Of Eau Claire | $2,286 | 97% |
| Healthpartners | $2,286 | 97% |
| Humana | $2,286 | 97% |
| Medica | $2,286 | 97% |
| Quartz Health Solutions | $2,286 | 97% |
| Security Health Plan Of Wi | $2,286 - $5,205 | 97% |
| Ucare Wi | $2,286 | 97% |
| UnitedHealthcare | $2,286 | 97% |
| Alliance | $3,429 | 145% |
Consumer Guidance & Cost Commentary
For this Cataract surgery with lens implant procedure at Oakleaf Surgical Hospital in Altoona, WI, the most significant benchmark is the Medicare amount of $2,357.81, which serves as a federal cost baseline for this service. The facility's gross charge is listed at $712, and the median negotiated rate for commercial payers is $2,286. While the facility is owned by a physician group, the data does not provide a state or county average for this specific procedure to allow for a direct local comparison.
The pricing structure shows that the median negotiated rate of $2,286 is lower than the Medicare benchmark of $2,357.81, which is notable as commercial rates often exceed Medicare amounts. Patients with high-deductible plans might find the cash price of $641 or the prompt-pay discount more advantageous than the standard insurance rate, as the negotiated ceiling of $2,286 includes administrative overhead that can inflate costs by 20% to 40%. It is recommended to confirm self-pay or prompt-pay discounts directly with the hospital before scheduling to ensure you receive the lowest possible rate, as billing systems may default to insurance processing if coverage is on file.