Screening mammogram (both breasts)
Facility: Overland Park Reg Med Ctr
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $313
- Cash Discount Price: $1,294
- vs. Medicare Baseline: 2.48x 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 248% of the Medicare baseline (a markup of 148%). 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 |
|---|---|---|
| Amerigroup | $72 | 57% |
| United | $72 - $707 | 57% |
| Healthyblue | $74 | 59% |
| Medicaid / KanCare | $74 | 59% |
| Aetna | $75 - $802 | 59% |
| Unicare | $75 | 59% |
| Triwest Health Alliance | $81 | 64% |
| Blue Cross Blue Shield | $81 - $676 | 64% |
| Coventry | $81 - $632 | 64% |
| Humana | $82 - $417 | 65% |
| Devoted Health | $82 | 65% |
| Wellcare | $84 | 67% |
| Celtic | $84 | 67% |
| Cigna | $84 - $163 | 67% |
| Pyramid Life | $88 | 70% |
| Home State Health Plan | $113 | 90% |
| Multiplan | $130 - $1,163 | 103% |
| Corvel Corporation | $155 - $1,022 | 123% |
| Oha Network | $161 - $786 | 128% |
| Ambetter / Centene | $219 - $292 | 173% |
| Nhc Advantage | $224 - $299 | 177% |
| Wppa Providrs Care Network | $236 - $314 | 187% |
| Universal Healthcare | $413 - $550 | 327% |
| Coventry Kc Mo | $484 - $644 | 383% |
| College Park Family Care Center | $507 - $676 | 402% |
| Cco, Inc. | $885 - $1,179 | 701% |
| Focus Healthcare Mgmt, Inc | $885 - $1,179 | 701% |
Consumer Guidance & Cost Commentary
For this screening mammogram procedure at Overland Park Reg Med Ctr, the cash price is $1,294.00, which matches the facility's cash median. While the facility's negotiated rates with major payers like United and Aetna range from $72 to $802, these amounts are still significantly higher than the cash price. This pricing structure highlights a common billing dynamic where paying out-of-pocket can be more cost-effective than using insurance, especially for patients with high deductibles or those who have already met their out-of-pocket maximum. To maximize savings, patients should inquire directly with the billing department about "self-pay" or "prompt-pay" discounts, which often reduce the final bill by 20% to 50% when paid in full upfront.
It is important to understand that commercial insurance rates are often inflated by administrative costs and contract structures, sometimes reaching 200% to 300% of the Medicare benchmark rate of $126.25 for this service. In this case, the facility's negotiated rates are well above the Medicare amount, reinforcing that the cash price represents a more transparent and lower-cost option. Patients should avoid accepting summary bills that obscure individual charges and instead request a detailed, itemized statement to ensure no errors exist before payment. Furthermore, if a patient encounters a balance bill from an out-of-network provider at this in-network facility, they may be protected under the No Surprises Act, which bans surprise billing for emergency and non-emergency services at in-network hospitals.