Diagnostic mammogram (both breasts)
Facility: Holton Community Hospital
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $269
- Cash Discount Price: $243
- vs. Medicare Baseline: 1.71x 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 |
|---|---|---|
| Blue Cross Blue Shield | $122 | 78% |
| Aetna | $172 - $324 | 110% |
| UnitedHealthcare | $172 - $324 | 110% |
| Humana | $173 | 110% |
| Kansas Superior Select - All Plans | $175 | 111% |
| Preferred Health Freedom | $269 | 171% |
| Preferred Health Fn Select - All Other Plans | $269 | 171% |
| Preferred Health Professionals | $269 | 171% |
| Wppa Providers - All Plans | $308 | 196% |
| Medicaid / KanCare | $324 | 206% |
Consumer Guidance & Cost Commentary
For the diagnostic mammogram of both breasts at Holton Community Hospital, the cash price of $243.00 is lower than the median negotiated rate of $269.00 paid by most insurers, including Aetna, UnitedHealthcare, and Humana. While the facility's cash rate is competitive, it is important to note that commercial insurance contracts often include administrative overhead that inflates the final allowed amount. Patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, which could result in a higher out-of-pocket expense if the deductible has not yet been met. Additionally, this facility is a Critical Access Hospital in Kansas, and while the specific county average is not listed, the cash rate remains below the median negotiated rate observed across the ten payers for this service.
To ensure you are not overcharged, it is advisable to request a prompt-pay discount or self-pay rate before scheduling your appointment, as these upfront payments can significantly reduce the total cost. If you do use insurance, be aware that the No Surprises Act protects you from balance billing for out-of-network providers at in-network facilities, but you should still verify that all ancillary services, such as lab work, are covered under your plan. Furthermore, if you receive a bill, always demand a full itemized statement rather than accepting a summary invoice, as over 80% of hospital bills contain errors such as unbundled codes or charges for services not rendered. Comparing your final allowed amount to the Medicare benchmark of $156.98 can also provide clarity on the facility's pricing structure, as commercial rates often exceed this federal baseline due to negotiated contract dynamics.