CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Ashland Health Center

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $200
  • Cash Discount Price: $160
  • vs. Medicare Baseline: 1.27x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Ashland Health Center is $200. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $160. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.27x the Medicare baseline. Located in 625 South Kentucky Street, Ashland, KS.
Cash / Self-Pay
$160

Average discount available for prompt cash payment at this facility.

Insurance Median
$200

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: $160 (102%)
Insurance Median: $200 (127%)
Cash: $160 (102% of Medicare)
Ins. Median: $200 (127% 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
Blue Cross Blue Shield $67 43%
Compalliance-All Plans $160 102%
Health Partners Of Kansas-All Plans $170 108%
Multiplan-All Plans $196 125%
Medica Mcare - All Plans $200 127%
Healthy Blue Mcr Adv - All Other Plans $200 127%
Medicare (plans) $200 127%
Medicaid / KanCare $200 127%
UnitedHealthcare $200 127%
Health Choice-All Plans $200 127%
Aetna $200 127%
Providers Care (Wppa)-All Plans $300 191%

Consumer Guidance & Cost Commentary

For the diagnostic mammogram (both breasts) at Ashland Health Center in Ashland, KS, the facility's cash price of $160.00 is lower than the median negotiated rate of $200.00 paid by most insurance plans. While the facility's cash rate is below the state average, patients with high-deductible plans may find paying the cash price directly more cost-effective than using insurance, as the negotiated rates often exceed the cash amount. It is important to note that the facility's cash price is also lower than the Medicare benchmark of $156.98, which serves as the federal baseline for evaluating hospital pricing markups.

Commercial insurance carriers negotiate rates that typically range from $67 to $300 for this service, with most plans settling at $200.00, which aligns with the facility's median negotiated rate. Because the facility is a Critical Access Hospital, patients should proactively ask about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the final bill by 20% to 50%. Additionally, since the No Surprises Act prohibits balance billing for out-of-network services at in-network facilities, patients can expect the hospital to adhere to the negotiated rates rather than charging the difference between the chargemaster and the insurance allowed amount.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 625 South Kentucky Street, Ashland, KS 67831
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals