Diagnostic mammogram (both breasts)
Facility: Rooks County Health Center
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $421
- Cash Discount Price: $350
- vs. Medicare Baseline: 2.68x 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 268% of the Medicare baseline (a markup of 168%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $123 | 78% |
| Veterans Admin - All Plans | $220 | 140% |
| Celtic Mcr Adv | $220 | 140% |
| Tricare | $220 | 140% |
| Celtic Comm - All Other Plans | $242 | 154% |
| Aetna | $421 | 268% |
| Preferred Benefits Admin | $421 | 268% |
| UnitedHealthcare | $421 | 268% |
| Health Partners - All Plans | $444 | 283% |
| Preferred Hlthcare - All Other Plans | $444 | 283% |
| Healthy Blue Mcaid - All Plans | $467 | 297% |
Consumer Guidance & Cost Commentary
For a diagnostic mammogram of both breasts at Rooks County Health Center in Plainville, Kansas, the cash price is $350.00, which is lower than the state average of $421.00. While the facility's negotiated rate for in-network insurance is $421.00, patients with high-deductible plans may find the cash price more beneficial if their insurance negotiated rate exceeds this amount. It is important to note that the facility is a Critical Access Hospital owned by a Government Hospital District, and commercial payers like Aetna and UnitedHealthcare pay the same $421.00 as the cash price, suggesting no additional administrative markup for these specific contracts.
The Medicare benchmark for this service is $156.98, which serves as the objective baseline for evaluating pricing markups. The facility's cash price of $350.00 represents a 2.7x multiplier compared to the Medicare rate, while the negotiated rate of $421.00 reflects the standard commercial pricing structure. To ensure you receive the best possible rate, we recommend requesting a full itemized bill to verify that no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors. Additionally, ask the billing department about prompt-pay discounts, which can reduce the total cost by 20% to 50% if you pay in full upfront, bypassing the administrative costs associated with insurance claims processing.