Screening mammogram (both breasts)
Facility: Kansas City Orthopaedic Institute
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $444
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 3.52x 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 352% of the Medicare baseline (a markup of 252%). 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 | $169 | 134% |
| Aetna | $171 | 135% |
| UnitedHealthcare | $171 | 135% |
| Blue Cross Blue Shield | $444 | 352% |
Consumer Guidance & Cost Commentary
For the screening mammogram (both breasts) at Kansas City Orthopaedic Institute in Leawood, KS, the facility's negotiated rate of $444.00 is significantly higher than the state average, which is 3.5 times the Medicare benchmark of $126.25. While this code is covered by four major payers including Cigna, Aetna, UnitedHealthcare, and Blue Cross Blue Shield, the data indicates that cash-pay options are not available for this service. Patients should note that while cash payments can sometimes be cheaper for those with high-deductible plans, this specific procedure does not offer a cash price, meaning the negotiated rate of $444.00 serves as the primary benchmark for in-network coverage.
Because this service is billed through insurance contracts, patients should be aware that their out-of-pocket costs depend entirely on their specific plan's deductible and copay structure rather than the facility's negotiated rate. Although the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, it is crucial to verify that the facility and the specific provider are fully in-network before scheduling to avoid unexpected charges. If you have already received a bill, you should request a formal itemized audit to ensure no errors exist, as over 80% of hospital bills contain mistakes such as unbundled codes or services not rendered. Additionally, since cash discounts are not applicable here, focus your negotiation efforts on confirming that your insurance has covered the full negotiated amount and that no surprise ancillary fees have been added.