Diagnostic mammogram (both breasts)
Facility: Mercy Hospital Pittsburg, Inc
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $158
- Cash Discount Price: $267
- vs. Medicare Baseline: 1.01x 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 $156.98 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 | $60 - $148 | 38% |
| Medicaid / KanCare | $60 - $166 | 38% |
| Tricare | $91 | 58% |
| Medicare (plans) | $91 - $96 | 58% |
| Aetna | $93 - $349 | 59% |
| Humana | $93 - $96 | 59% |
| Elara Caring Aspire Hospice [20433] | $96 | 61% |
| Dept Of Veteran Affairs Contracted [320106] | $96 | 61% |
| Halo Hcr Inc Hospice [20432] | $96 | 61% |
| Pace Of The Ozarks Contracted [320518] | $96 | 61% |
| Kindful Hospice Contracted [320434] | $96 | 61% |
| Halo Hcr Inc Hospice Contracted [320432] | $96 | 61% |
| Kindful Hospice [20434] | $96 | 61% |
| Cross Timbers Hospice [20098] | $96 | 61% |
| Mercy Hospice Okc [20252] | $96 | 61% |
| UnitedHealthcare | $100 - $277 | 64% |
| American Health Advantage Of Ks Mcr Contracted [320508] | $101 | 64% |
| Medica Contracted [320239] | $150 | 96% |
| Ambetter / Centene | $166 | 106% |
| Home State Health Plan Contracted [320187] | $166 | 106% |
| Providrs Care Network Contracted [320484] | $186 | 118% |
| United Medical Resources Contracted [320454] | $277 | 176% |
| Health Choice Contracted [320166] | $278 | 177% |
| Ebms Contracted [320493] | $329 | 210% |
| Healthlink Contracted [320179] | $329 | 210% |
| Workers Comp [20426] | $329 | 210% |
| American Healthcare Alliance Contracted [320020] | $329 | 210% |
| Yuzu Health Contracted [320521] | $329 | 210% |
| Mercy Benefit Admin Contracted [320251] | $329 | 210% |
| Edison Health Solutions Contracted [320502] | $329 | 210% |
| Reflect Health Contracted [320492] | $329 | 210% |
| Aither Health Contracted [320449] | $329 | 210% |
| Auxiant Contracted [320462] | $329 | 210% |
| Imagine 360 Contracted [320494] | $329 | 210% |
| First Health Contracted [320128] | $349 | 222% |
| Cigna | $495 - $507 | 315% |
Consumer Guidance & Cost Commentary
For the diagnostic mammogram of both breasts (CPT 77066) at Mercy Hospital Pittsburg, Inc., the cash price is $267.00, while the facility's negotiated rates with insurance payers range from $60 to $507. Notably, the cash price is lower than the lowest negotiated rate found for Blue Cross Blue Shield ($60) and Medicaid/KanCare ($60), though higher than the median negotiated amount of $158.00. Patients with high-deductible plans may find paying the cash price of $267.00 more cost-effective than relying on insurance, as some negotiated rates exceed this amount. It is advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can further reduce the final out-of-pocket cost.
The facility's pricing is benchmarked against Medicare, which sets a fixed rate of $156.98 for this procedure. The cash price of $267.00 represents a markup of approximately 70% over the Medicare rate, while the median negotiated rate of $158.00 is only slightly above the Medicare benchmark. This data suggests that the facility's commercial pricing structure is relatively close to the federal cost baseline, particularly when compared to the gross charge of $411.00. Consumers should be aware that balance billing is generally prohibited for emergency services at in-network facilities under the No Surprises Act, and patients should request an itemized bill to ensure no unbundled charges or services not rendered are included in the final invoice.