Screening mammogram (both breasts)
Facility: Rooks County Health Center
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $295
- Cash Discount Price: $277
- vs. Medicare Baseline: 2.34x 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 234% of the Medicare baseline (a markup of 134%). 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 |
|---|---|---|
| Celtic Mcr Adv | $154 - $193 | 122% |
| Veterans Admin - All Plans | $154 - $193 | 122% |
| Tricare | $154 - $193 | 122% |
| Blue Cross Blue Shield | $161 | 128% |
| Celtic Comm - All Other Plans | $170 - $212 | 135% |
| Preferred Benefits Admin | $295 - $370 | 234% |
| UnitedHealthcare | $295 - $370 | 234% |
| Aetna | $295 - $370 | 234% |
| Preferred Hlthcare - All Other Plans | $312 - $390 | 247% |
| Health Partners - All Plans | $312 - $390 | 247% |
| Healthy Blue Mcaid - All Plans | $328 - $411 | 260% |
Consumer Guidance & Cost Commentary
For a screening mammogram at Rooks County Health Center in Plainville, KS, the facility's cash price is $277, which is lower than the state average of $295. While the facility's negotiated rates with major payers like UnitedHealthcare and Aetna range from $295 to $370, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying out-of-pocket. It is important to note that the facility is a Critical Access Hospital owned by a Government Hospital District, and while the cash rate is competitive, patients should verify if their specific insurance plan has a lower allowed amount before scheduling.
The Medicare benchmark for this service is $126.25, which serves as a baseline for evaluating the facility's pricing structure. Although the facility's cash rate is higher than the Medicare amount, it remains below the median negotiated rate of $295 reported across the region. Consumers should be aware that commercial insurance contracts often include administrative overhead that inflates the baseline price, and while the No Surprises Act protects against balance billing for out-of-network services at in-network facilities, patients should still request a prompt-pay discount if they choose to pay cash directly. Always ask the billing department about self-pay rates and prompt-pay incentives before check-in to ensure you are not paying the full negotiated amount.