Diagnostic mammogram (both breasts)
Facility: Saint Luke'S South Hospital
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $159
- Cash Discount Price: $156
- vs. Medicare Baseline: 1.01x 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 |
|---|---|---|
| Medicaid / KanCare | $60 - $200 | 38% |
| Cigna | $88 - $340 | 56% |
| Transplants-Case Rates [5750] | $91 - $260 | 58% |
| UnitedHealthcare | $104 - $201 | 66% |
| Aetna | $114 - $247 | 73% |
| Humana | $117 - $191 | 75% |
| Blue Cross Blue Shield | $117 - $195 | 75% |
| Commercial-Contracted [8000] | $146 - $210 | 93% |
| First Health [5512] | $154 | 98% |
Consumer Guidance & Cost Commentary
For the diagnostic mammogram of both breasts (CPT 77066) at Saint Luke's South Hospital in Overland Park, KS, the cash median price is $156.00, which is lower than the facility's negotiated rates for most commercial payers. While the hospital's negotiated rates range from $60 to $340 depending on the insurance plan, the cash price serves as a useful benchmark for patients with high-deductible plans who may find paying out-of-pocket cheaper than the insurance allowed amount. It is important to note that commercial negotiated rates often include administrative overhead and contract dynamics that can inflate the baseline price by 20% to 40% compared to the actual cost of care.
The facility's pricing aligns closely with the Medicare benchmark, with a gross charge of $260.00 and a Medicare amount of $156.98, indicating a markup consistent with the 100% to 150% range often seen in fair pricing models. Patients should be aware that while the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, it is still advisable to request an itemized billing audit before finalizing payment to ensure no unbundled codes or services not rendered are included. Additionally, asking about self-pay or prompt-pay discounts prior to scheduling can help avoid unexpected costs, as hospitals may offer significant fee reductions for upfront payment to bypass costly claims processing.