Screening mammogram (both breasts)
Facility: Ashland Health Center
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $224
- Cash Discount Price: $179
- vs. Medicare Baseline: 1.77x 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.
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 |
|---|---|---|
| Blue Cross Blue Shield | $75 | 59% |
| Compalliance-All Plans | $179 | 142% |
| Health Partners Of Kansas-All Plans | $190 | 150% |
| Multiplan-All Plans | $220 | 174% |
| Aetna | $224 | 177% |
| Medicaid / KanCare | $224 | 177% |
| Health Choice-All Plans | $224 | 177% |
| Medicare (plans) | $224 | 177% |
| UnitedHealthcare | $224 | 177% |
| Medica Mcare - All Plans | $224 | 177% |
| Healthy Blue Mcr Adv - All Other Plans | $224 | 177% |
| Providers Care (Wppa)-All Plans | $336 | 266% |
Consumer Guidance & Cost Commentary
For the screening mammogram (both breasts) at Ashland Health Center, the facility's cash price of $179.00 is lower than the median negotiated rate of $224.00 paid by most insurance plans, including Blue Cross Blue Shield, Aetna, and UnitedHealthcare. While the facility is a Critical Access Hospital in Ashland, KS, with a gross charge of $224.00, patients with high-deductible plans or those without insurance may find the cash price more advantageous. It is important to note that commercial negotiated rates often include administrative overhead and are not always the lowest possible cost; in this case, the cash rate is $45.00 less than the median amount insurers pay. Patients should verify if their specific plan has a lower allowed amount or if they qualify for a self-pay or prompt-pay discount before scheduling.
The facility's pricing aligns with the Medicare benchmark of $126.25, with the cash rate representing a 37% increase over the federal baseline, which is consistent with fair pricing standards for this service type. Since the No Surprises Act prohibits balance billing for out-of-network providers at in-network facilities, patients should be aware that the $224.00 rate shown for most payers reflects the contractual ceiling rather than an unexpected surprise bill. If a patient receives an itemized bill that exceeds the cash price or the Medicare rate, they should request a formal itemized billing audit to identify potential errors, such as unbundled codes or services not rendered, before agreeing to pay the full amount. Always confirm the final out-of-pocket cost with the hospital's billing department, as prompt-pay discounts may further