Diagnostic mammogram (both breasts)
Facility: Nemaha Valley Community Hospital
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $131
- Cash Discount Price: $231
- vs. Medicare Baseline: 0.83x 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.
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 |
|---|---|---|
| Humana | $107 - $119 | 68% |
| Va Ccn - All Plans | $107 - $119 | 68% |
| Aetna | $108 - $230 | 69% |
| Celtic Comm Exch - All Plans | $118 - $131 | 75% |
| Blue Cross Blue Shield | $123 | 78% |
| Partners Direct Health - All Plans | $126 - $141 | 80% |
| Multiplan - All Plans | $219 - $244 | 140% |
| Midlands Choice - All Plans | $231 - $257 | 147% |
| Health Partners - All Plans | $231 - $257 | 147% |
Consumer Guidance & Cost Commentary
For the diagnostic mammogram (both breasts) at Nemaha Valley Community Hospital in Seneca, KS, the facility's cash price of $231.00 is notably higher than the state average of $174.00. While commercial insurance plans like Aetna and Multiplan have negotiated rates ranging from $107 to $257, 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 insurance negotiated rates can sometimes be inflated by administrative costs and contract dynamics, so verifying the allowed amount before scheduling is crucial. Additionally, because this facility is a Critical Access Hospital, patients should explicitly ask about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid upfront, bypassing the overhead associated with insurance claims processing.
When evaluating the cost relative to federal standards, the facility's cash rate of $231.00 represents a markup of 0.8 times the Medicare amount of $156.98. Although the facility is a voluntary non-profit, commercial rates here can vary significantly by payer, with some plans paying as high as $257.00 versus the median negotiated rate of $131.00. Consumers should avoid assuming that being in-network guarantees the lowest price, as different insurers have distinct contract ceilings. To ensure you are not overcharged, request a full itemized billing audit to review every line item and confirm that no services were billed for that were not rendered, as errors are common in hospital billing. Finally, if you receive a balance bill from an