Diagnostic mammogram (both breasts)
Facility: Mcpherson Hospital
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $144
- Cash Discount Price: $299
- vs. Medicare Baseline: 0.92x 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 |
|---|---|---|
| UnitedHealthcare | $38 - $570 | 24% |
| Tricare | $39 - $127 | 25% |
| Blue Cross Blue Shield | $44 - $144 | 28% |
| Humana | $44 - $144 | 28% |
| Ambetter / Centene | $44 - $166 | 28% |
| Healthy Blue Mcr Adv | $44 - $144 | 28% |
| Wellcare Mcr Adv - All Plans | $44 - $144 | 28% |
| Aetna | $44 - $570 | 28% |
| Va Ccn - All Plans | $44 - $144 | 28% |
| Multiplan - All Plans | $55 - $513 | 35% |
| Medicaid / KanCare | $126 - $570 | 80% |
| Health Blue Mcaid - All Other Plans | $128 - $581 | 82% |
| Medical Associates - All Plans | $178 - $428 | 113% |
| Central Plains - All Plans | $178 - $428 | 113% |
| Health Partners - All Plans | $226 - $542 | 144% |
| Cigna | $226 - $542 | 144% |
| Wppa - All Plans | $399 | 254% |
| Christian Health Aid - All Plans | $456 | 290% |
| First Health - All Plans | $542 | 345% |
Consumer Guidance & Cost Commentary
For the diagnostic mammogram (both breasts) at McPherson Hospital in McPherson, KS, the cash price is $299.00, which is lower than the facility's negotiated rates of $144.00 and the state median paid amount of $428.00. While commercial payers like UnitedHealthcare and Aetna have negotiated rates ranging from $38 to $570, patients with high-deductible plans may find the cash price more advantageous if their insurance allowed amount exceeds $299.00. It is important to note that while the facility is an in-network Acute Care Hospital, the No Surprises Act generally protects patients from balance billing for out-of-network services at in-network facilities, though patients should still verify their specific plan's allowed amount before scheduling to avoid unexpected costs.
Facility pricing should be evaluated against the Medicare benchmark of $156.98, which serves as the objective baseline for true cost rather than the hospital's inflated gross charge of $404.00. Although the facility's facility rating is 2, the cash price of $299.00 remains competitive relative to the Medicare rate, suggesting a markup that aligns with fair pricing standards rather than excessive administrative inflation. Patients are encouraged to request a prompt-pay discount if paying in full upfront, as this can reduce the bill by 20% to 50% and bypass costly insurance claims processing. Additionally, if a summary bill is received, patients should demand a full itemized audit to identify any unbundled codes or services not rendered, ensuring the final invoice accurately reflects the care provided.