CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Graham County Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $144
  • Cash Discount Price: $162
  • vs. Medicare Baseline: 0.92x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Graham County Hospital is $144. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $162. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 0.92x the Medicare baseline. Located in 304 West Prout Street, Hill City, KS.
Cash / Self-Pay
$162

Average discount available for prompt cash payment at this facility.

Insurance Median
$144

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$156.98

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $156.98 (100%)
Cash / Self-Pay: $162 (103%)
Insurance Median: $144 (92%)
Cash: $162 (103% of Medicare)
Ins. Median: $144 (92% of 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicare (plans) $122 78%
Blue Cross Blue Shield $122 78%
UnitedHealthcare $130 - $201 83%
Celtic Commercial-All Other Plans $134 85%
Wppa (Providers Care)-All Plans $154 98%
Medicaid / KanCare $201 128%

Consumer Guidance & Cost Commentary

For a diagnostic mammogram at Graham County Hospital in Hill City, Kansas, the cash price is $162.00, which matches the facility's median negotiated rate of $144.00 and the median paid amount of $134.00. While commercial payers like UnitedHealthcare and Medicaid / KanCare have negotiated rates ranging from $130 to $201, the cash price remains the lowest option available for this service. Patients with high-deductible plans should consider paying cash directly, as the $162.00 rate is significantly lower than the average commercial negotiated rates, potentially saving money compared to insurance reimbursement. It is important to note that while the facility is a Critical Access Hospital owned by the local government, the cash price does not automatically include any potential prompt-pay discounts; patients should explicitly ask the billing department about self-pay or prompt-pay incentives before scheduling to ensure they are receiving the lowest possible rate.

The Medicare benchmark for this procedure is $156.98, which serves as a reliable baseline for evaluating the facility's pricing structure. Although the facility's cash rate of $162.00 is slightly higher than the Medicare amount, it is comparable to the commercial negotiated rates seen across various payers, indicating that the facility is not charging excessive markups above the true cost of care. Because the cash price is lower than the median paid amount of $134.00, patients who utilize insurance may end up paying more out-of-pocket if their deductible has not been met or if the insurance allowed amount exceeds the cash price. To avoid unexpected costs, consumers should request an itemized bill to verify that no unbundled codes

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 304 West Prout Street, Hill City, KS 67642
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals