Screening mammogram (both breasts)
Facility: Nemaha Valley Community Hospital
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $126
- Cash Discount Price: $198
- vs. Medicare Baseline: 1.00x 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 |
|---|---|---|
| Va Ccn - All Plans | $87 - $107 | 69% |
| Humana | $87 - $107 | 69% |
| Aetna | $88 - $207 | 70% |
| Celtic Comm Exch - All Plans | $96 - $118 | 76% |
| Partners Direct Health - All Plans | $103 - $126 | 82% |
| Blue Cross Blue Shield | $161 | 128% |
| Multiplan - All Plans | $178 - $219 | 141% |
| Health Partners - All Plans | $188 - $231 | 149% |
| Midlands Choice - All Plans | $188 - $231 | 149% |
Consumer Guidance & Cost Commentary
For the screening mammogram (both breasts) at Nemaha Valley Community Hospital in Seneca, KS, the cash price of $198.00 is lower than the average negotiated rate of $126.00 paid by insurance plans. While the facility's cash price is competitive, patients with high-deductible plans may find it beneficial to pay the cash price directly, as the insurance negotiated rates for this service often exceed the cash amount. The hospital offers a prompt-pay discount for upfront payment, which can further reduce the total cost, though patients should verify self-pay rates before scheduling to ensure the billing system does not automatically submit claims to insurance.
When comparing pricing to federal benchmarks, the Medicare rate for this procedure is $126.25, which serves as the objective baseline for evaluating hospital markups. The facility's cash price of $198.00 is approximately 157% of the Medicare rate, aligning with the typical range for fair pricing rather than the higher commercial averages of 200% to 300%. Since the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients should request an itemized billing audit to confirm that no unbundled codes or services not rendered are included in the final statement.