CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Kossuth Regional Health Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $326
Cash Discount Price: $327
vs. Medicare Baseline: 2.58x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Kossuth Regional Health Center is $326. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $327. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.58x the Medicare baseline. Located in 1515 South Phillips Street, Algona, IA.

Cash / Self-Pay

$327

Average discount available for prompt cash payment at this facility.

Insurance Median

$326

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$126.25

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $126.25 (100%)

Cash / Self-Pay: $327 (259%)

Insurance Median: $326 (258%)

Cash: $327 (259% of Medicare)

Ins. Median: $326 (258% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $126.25 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 258% of the Medicare baseline (a markup of 158%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$61 - $67	48%
Mercy One - All Plans	$133 - $178	105%
Va Ccn - All Plans	$133 - $178	105%
Humana	$134 - $180	106%
Amerigroup Mcr Adv - All Other Plans	$135 - $181	107%
UnitedHealthcare	$137 - $355	109%
Health Partners New Bus - All Other Plans	$244 - $328	193%
Midlands Choice - All Plans	$244 - $328	193%
Medical Associates - All Plans	$297 - $398	235%
Preferred Health - All Plans	$297 - $398	235%
Aetna	$325 - $454	257%
Multiplan - All Plans	$332 - $445	263%
Health Partners Exisiting Bus	$339 - $454	269%
Molina Mcaid/Chip - All Plans	$359 - $482	284%
Amerigroup Mcaid	$363 - $487	288%

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 $327.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77067.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Kossuth Regional Health Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77067.
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.