Screening mammogram (both breasts)
Facility: Wichita County Health Center
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $215
- Cash Discount Price: $189
- vs. Medicare Baseline: 1.70x 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 |
|---|---|---|
| Medicaid / KanCare | $195 | 154% |
| UnitedHealthcare | $236 | 187% |
Consumer Guidance & Cost Commentary
For a screening mammogram at Wichita County Health Center in Leoti, Kansas, the facility's cash price of $189.00 is lower than the state average of $215.00, making it a cost-effective option for self-pay patients. While the facility is a Critical Access Hospital owned by the local government, the negotiated rate for UnitedHealthcare is $236.00, which is higher than the cash price. This pricing structure highlights a common billing dynamic where commercial insurance contracts often exceed cash rates due to administrative overhead and contract dynamics; therefore, patients with high-deductible plans or those without insurance may save money by paying the cash price directly. It is advisable to confirm "self-pay" or "prompt-pay" discounts with the hospital before scheduling, as these upfront payment incentives can further reduce the final cost.
When evaluating the financial impact of this service, it is important to compare the facility's rates against the Medicare benchmark of $126.25, which serves as the objective baseline for healthcare delivery costs. The facility's cash rate of $189.00 represents a markup of 1.7 times the Medicare amount, while the UnitedHealthcare negotiated rate of $236.00 exceeds the Medicare benchmark by a significant margin. Patients should be aware that commercial rates often include additional costs for claims processing and utilization reviews, which can inflate the baseline price by 20% to 40% compared to the true cost of care. To ensure transparency, consumers should request an itemized bill to verify that no unbundled codes or services not rendered are included, and they should check their specific plan details to understand whether their deductible has been met