Screening mammogram (both breasts)
Facility: University Of Kansas Health System - St Francis Campus
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $257
- Cash Discount Price: $188
- vs. Medicare Baseline: 2.04x 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 $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 204% of the Medicare baseline (a markup of 104%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Oscar Exchange [6080] | $219 | 173% |
| Oncology Patient Assistance Programs [2295] | $257 | 204% |
| Web Tpa [2115] | $257 | 204% |
| Hooray Health [8000] | $257 | 204% |
| Aetna | $257 | 204% |
| Lucent Health [6000] | $257 | 204% |
| Blue Cross Blue Shield | $257 | 204% |
| Black Lung [6055] | $257 | 204% |
| Healthcare Highways [2210] | $257 | 204% |
| Department Of Corrections [1340] | $313 - $814 | 248% |
| American Postal Workers Union [1070] | $362 | 287% |
| National Association Of Letter Carriers [1695] | $362 | 287% |
| Cigna | $362 | 287% |
| Healthpartners [1500] | $362 | 287% |
| Humana | $369 | 292% |
| Administrative Concepts [1005] | $486 | 385% |
| Multiplan [1680] | $486 | 385% |
| First Health [1375] | $486 | 385% |
| American Healthcare [1055] | $486 | 385% |
| Coventry Healthcare [1320] | $513 | 406% |
| Ks Disability Determination [6090] | $626 | 496% |
Consumer Guidance & Cost Commentary
For a screening mammogram at the University Of Kansas Health System - St Francis Campus in Topeka, the facility's cash price of $188.00 is significantly lower than the median negotiated rate of $257.00 paid by most insurance plans. While the gross charge listed is $626.00, patients with high-deductible plans may find the cash price more affordable if their insurance negotiated rate exceeds this amount. It is important to note that the cash price of $188.00 is also lower than the Medicare benchmark of $126.25 when adjusted for the facility's specific pricing context, though the primary comparison for consumers is often between the cash rate and the insurance allowed amount. To minimize costs, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the administrative overhead and higher negotiated rates associated with insurance billing.
The data indicates that 21 different payers have negotiated rates for this service, with the majority of plans agreeing to pay a fixed amount of $257.00, while a few specific payers have a range between $313.00 and $814.00. Because the facility is an in-network location for most of these carriers, the No Surprises Act generally protects patients from balance billing for out-of-network services at this acute care hospital. However, patients should remain vigilant regarding itemized billing audits, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. If a patient receives a summary bill, they should request a full, line-by-line C