CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Providence Medical Center

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $129
  • Cash Discount Price: $99
  • vs. Medicare Baseline: 0.82x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Providence Medical Center is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $99. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 0.82x the Medicare baseline. Located in 8929 Parallel Parkway, Kansas City, KS.
Cash / Self-Pay
$99

Average discount available for prompt cash payment at this facility.

Insurance Median
$129

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%)
Cash / Self-Pay: $99 (63%)
Insurance Median: $129 (82%)
Cash: $99 (63% of Medicare)
Ins. Median: $129 (82% 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
Medicaid / KanCare $60 38%
Aetna $77 - $209 49%
Midland Care Connection $100 64%
Tricare $100 64%
Medicare (plans) $100 64%
UnitedHealthcare $100 - $193 64%
Blue Cross Blue Shield $100 - $235 64%
Cigna $100 64%
Celtic $105 - $159 67%
Kansas Superior Select $105 67%
Healthy Blue $105 - $128 67%
Corizon $130 83%
Employer Direct Healthcare $140 89%
Well Path Prison $140 89%
Early Detection Works $147 94%
Centurion $150 96%
Naphcare $154 98%
Comp Alliance - Fka Compresults Worker Compensation $178 113%
Oha Networks $191 122%
Worker Compensation $197 125%
First Health $750 478%

Consumer Guidance & Cost Commentary

For the diagnostic mammogram of both breasts at Providence Medical Center in Kansas City, KS, the facility's cash price of $99.00 is significantly lower than the state average of $156.98 and the Medicare benchmark of $156.98. While many commercial payers negotiate rates ranging from $60 to $235, the cash rate of $99.00 represents a substantial discount compared to the median negotiated amount of $129.00. Patients with high-deductible plans or those who have already met their out-of-pocket maximum may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates for some carriers exceed the cash rate. It is advisable to contact the hospital directly to confirm if "self-pay" or "prompt-pay" discounts are available, as these upfront payment incentives can further reduce the final cost.

Although the No Surprises Act generally protects patients from balance billing for out-of-network services at in-network facilities, it is important to review any itemized billing statements carefully to ensure no unexpected ancillary charges are included. If a patient receives a summary bill, they should request a full, line-by-line itemized statement to identify potential errors, unbundled codes, or services not rendered, as over 80% of hospital bills contain inaccuracies. Disputing errors should be done in writing to the billing supervisor rather than relying on verbal assurances, and patients should avoid signing consent waivers that might inadvertently waive their rights regarding surprise billing protections. By understanding the difference between the facility's gross charges, the Medicare benchmark, and the actual negotiated rates, consumers can make informed decisions about their healthcare spending.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 8929 Parallel Parkway, Kansas City, KS 66112
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals