Diagnostic mammogram (both breasts)
Facility: Nmc Health
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $237
- Cash Discount Price: $230
- vs. Medicare Baseline: 1.51x 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 | $123 | 78% |
| Wppa | $161 - $200 | 103% |
| Occunet | $175 - $218 | 111% |
| Medincrease Health Plan | $190 - $237 | 121% |
| Samaritan Ministries International | $190 - $237 | 121% |
| Prime Health Services | $219 - $273 | 140% |
| Aetna | $241 - $300 | 154% |
| UnitedHealthcare | $263 - $328 | 168% |
| Cigna | $277 - $346 | 176% |
Consumer Guidance & Cost Commentary
For this diagnostic mammogram at Nmc Health in Newton, Kansas, the cash price is $230, which is lower than the facility's gross charge of $328. While the facility's negotiated rates with major payers like UnitedHealthcare and Aetna range from $263 to $328, the cash price offers a potential savings for patients with high-deductible plans or those without insurance. It is important to note that commercial negotiated rates often exceed cash prices due to administrative costs and contract structures, meaning paying out-of-pocket upfront can sometimes be the most economical option. Patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can bypass the standard insurance billing cycle and lower the final amount owed.
The facility's pricing is significantly higher than the Medicare benchmark for this service, which is set at $156.98. This markup reflects the commercial pricing model used by private insurers, where rates are often 1.5 times the Medicare amount. Because over 80% of hospital bills contain errors, patients should request a detailed, itemized bill rather than accepting a summary invoice that may hide unbundled charges or services not rendered. If a balance bill arises from an out-of-network provider or ancillary service, the No Surprises Act may protect you from paying the difference; in such cases, do not pay immediately and instead dispute the bill with your insurer to request an audit. Always verify your deductible status before using insurance, as paying the full negotiated rate without meeting your deductible can result in higher out-of-pocket costs than paying cash directly.