CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Stormont Vail Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $120
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.76x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Stormont Vail Hospital is $120. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 0.76x the Medicare baseline. Located in 1500 Sw 10Th Avenue, Topeka, KS.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$120

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$156.98

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $156.98 (100%)
Insurance Median: $120 (76%)
Ins. Median: $120 (76% of 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.

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
Ambetter / Centene $61 - $128 39%
UnitedHealthcare $61 - $128 39%
Blue Cross Blue Shield $62 - $130 39%

Consumer Guidance & Cost Commentary

For the diagnostic mammogram of both breasts at Stormont Vail Hospital in Topeka, KS, the facility's negotiated rates range from $61 to $130 across three major payers, with a median paid amount of $129.00. This negotiated rate is significantly higher than the Medicare benchmark of $156.98, which serves as the federal cost baseline for this service. While commercial insurance contracts often result in higher out-of-pocket costs due to administrative overhead and multi-layered pricing structures, patients with high-deductible plans may find that paying the cash price directly is more economical. Although the cash median is not available in this dataset, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the administrative costs associated with insurance billing cycles.

It is important to note that while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, unexpected charges can still occur if ancillary services like emergency physicians or lab tests are billed separately. To avoid these surprises, consumers should request a full itemized CPT-coded bill rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. If a discrepancy is found, a formal written audit dispute sent to the billing supervisor is the most effective method to resolve errors and reduce medical debt. Ultimately, comparing the facility's specific negotiated rates against the state average and verifying your deductible status before the procedure can help ensure you are not paying more than necessary for this essential diagnostic service.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1500 Sw 10Th Avenue, Topeka, KS 66604
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals