Diagnostic mammogram (both breasts)
Facility: Kansas City Orthopaedic Institute
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $548
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 3.49x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 349% of the Medicare baseline (a markup of 249%). 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 |
|---|---|---|
| Cigna | $208 | 133% |
| UnitedHealthcare | $211 | 134% |
| Aetna | $211 | 134% |
| Blue Cross Blue Shield | $548 | 349% |
Consumer Guidance & Cost Commentary
For the diagnostic mammogram of both breasts (CPT 77066) at Kansas City Orthopaedic Institute in Leawood, KS, the facility's negotiated rate is $548.00, which aligns exactly with the state average for this service. This rate is significantly higher than the Medicare benchmark of $156.98, reflecting the standard administrative markup inherent in commercial insurance contracts. While the facility's negotiated rate is $548.00, patients should be aware that cash-pay options may offer a lower total cost, particularly for those with high-deductible plans where the insurance allowed amount might exceed the cash price. It is advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can reduce the final bill by 20% to 50% if paid in full upfront.
Patients should also be cautious regarding balance billing, especially if they receive care from out-of-network providers or ancillary services like emergency physicians or labs, as these can trigger unexpected bills for the difference between the chargemaster rate and the insurance allowed amount. However, federal protections under the No Surprises Act generally ban balance billing for emergency care and non-emergency services from out-of-network providers at in-network facilities. If a patient receives an itemized bill that appears inflated or contains errors, such as unbundled codes or services not rendered, they should request a formal written audit dispute rather than accepting a summary bill or settling verbally. Always verify your deductible status before scheduling, as paying out-of-pocket without meeting your deductible could result in paying the full negotiated rate rather than a reduced share.