Screening mammogram (both breasts)
Facility: Pratt Regional Medical Center
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $278
- Cash Discount Price: $216
- vs. Medicare Baseline: 2.20x 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 220% of the Medicare baseline (a markup of 120%). 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 | $206 - $318 | 163% |
| UnitedHealthcare | $229 - $432 | 181% |
| Health Partners Of Kansas | $234 - $360 | 185% |
| Aetna | $248 - $382 | 196% |
| Choicecare | $275 - $424 | 218% |
Consumer Guidance & Cost Commentary
For a screening mammogram at Pratt Regional Medical Center in Pratt, KS, the facility's cash median rate of $216.00 is notably lower than the negotiated rates paid by major insurers like UnitedHealthcare ($229–$432) and Aetna ($248–$382). While the facility's gross charge is $309.00, patients with high-deductible plans or those without insurance may find the cash price more affordable than their insurance negotiated rate, which often includes administrative overhead. It is important to note that the facility's negotiated rate of $278.00 is higher than the cash price, illustrating how upfront payment can sometimes result in significant savings compared to standard insurance processing.
The facility's pricing is also evaluated against federal benchmarks, showing a markup of 2.2 times the Medicare amount of $126.25. Although the facility holds a 4-star rating and is a Proprietary Acute Care Hospital, patients should be aware that commercial rates often exceed the "true cost" represented by Medicare. To maximize savings, consumers should explicitly request self-pay or prompt-pay discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%. Additionally, patients should avoid accepting summary bills and instead demand a full itemized statement to ensure no errors or unbundled charges are included in the final invoice.