Diagnostic mammogram (both breasts)
Facility: Pratt Regional Medical Center
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $514
- Cash Discount Price: $411
- vs. Medicare Baseline: 3.27x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 327% of the Medicare baseline (a markup of 227%). 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 |
|---|---|---|
| Christian Health Aid | $440 | 280% |
| UnitedHealthcare | $488 - $599 | 311% |
| Health Partners Of Kansas | $499 | 318% |
| Aetna | $528 | 336% |
| Choicecare | $587 | 374% |
Consumer Guidance & Cost Commentary
For a diagnostic mammogram at Pratt Regional Medical Center in Pratt, KS, the cash price of $411.00 is significantly lower than the facility's gross charge of $587.00. While the negotiated rates for in-network payers like UnitedHealthcare and Aetna range from $488 to $599, the cash price offers a substantial alternative for those without insurance or with high-deductible plans. It is important to note that commercial negotiated rates often include administrative overhead and contract dynamics that can make them higher than the cash price, even for patients with active coverage. Patients should verify their specific plan's deductible status before scheduling, as paying the full negotiated rate may not be cost-effective if the deductible has not yet been met.
When evaluating the cost against national standards, the Medicare benchmark for this procedure is $156.98. The facility's cash rate of $411.00 is approximately 2.6 times the Medicare amount, which falls within the typical range where commercial rates can vary significantly from the federal baseline. While the facility is a Proprietary Acute Care Hospital with a 4-star rating, patients should proactively ask about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full upfront. To ensure accuracy, consumers should request an itemized bill that breaks down every CPT code and service rendered, as summary bills often obscure individual charges and potential errors.