CMS Price Transparency Data

Cataract surgery with lens implant

Facility: Wamego Health Center

Billing Code: 66984 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 66984
  • Insurance Median: $676
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.29x Medicare
The contracted insurance negotiated median rate for a Cataract surgery with lens implant at Wamego Health Center is $676. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $2,357.81, this hospital’s rate is 0.29x the Medicare baseline. Located in 711 Genn Drive, Wamego, KS.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$676

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%)
Insurance Median: $676 (29%)
Ins. Median: $676 (29% 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
UnitedHealthcare $650 28%
Providrs Care $667 28%
Aetna $676 29%
Medicaid / KanCare $676 - $682 29%
Tricare $1,730 73%
Blue Cross Blue Shield $3,554 - $3,741 151%

Consumer Guidance & Cost Commentary

For patients undergoing cataract surgery with lens implant at Wamego Health Center in Wamego, KS, the financial landscape varies significantly depending on payment method. While the facility's median negotiated rate for in-network payers like UnitedHealthcare and Aetna is $676, the cash median is not listed in the current data. It is important to note that cash-pay options can sometimes be cheaper for patients with high-deductible plans if the insurance negotiated rate exceeds the cash price, though this specific comparison is unavailable here. Patients should always verify "self-pay" or "prompt-pay" discounts directly with the hospital before scheduling, as these upfront incentives can bypass the administrative costs associated with insurance billing cycles.

When evaluating costs against federal benchmarks, the Medicare amount for this procedure is $2,357.81. The data indicates a variance of 0.3 compared to Medicare, suggesting the facility's pricing structure is closely aligned with federal standards rather than significantly inflated. Although specific county or state average comparisons are not provided in the available dataset, the facility operates as a Critical Access Hospital with a voluntary non-profit ownership structure. Consumers are advised to request an itemized billing audit if they receive a summary bill, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, under the No Surprises Act, patients are protected from balance billing for out-of-network providers at in-network facilities, and any unexpected bills should be disputed in writing with the insurer rather than paid immediately.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 711 Genn Drive, Wamego, KS 66547
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals