Diagnostic mammogram (both breasts)
Facility: Ellsworth County Medical Center
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $383
- Cash Discount Price: $425
- vs. Medicare Baseline: 2.44x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 244% of the Medicare baseline (a markup of 144%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $116 - $122 | 74% |
| Healthy Blue Mcr Adv | $200 | 127% |
| Humana | $200 - $404 | 127% |
| Va Ccn-All Plans | $200 | 127% |
| Triwest -All Plans | $200 | 127% |
| UnitedHealthcare | $276 - $425 | 176% |
| First Health - All Plans | $382 | 243% |
| Aetna | $382 | 243% |
| Cigna | $404 | 257% |
| Coventry Mcaid-All Plans | $425 | 271% |
| Medicaid / KanCare | $425 | 271% |
| Healthy Blue Mcaid- All Other Plans | $425 | 271% |
| Providers Care-Wppa-All Plans | $638 | 406% |
Consumer Guidance & Cost Commentary
For the diagnostic mammogram of both breasts (CPT 77066) at Ellsworth County Medical Center in Ellsworth, Kansas, the cash price is $425.00, which matches the facility's gross charge and the median cash rate. This cash price is significantly higher than the state average for this procedure, as indicated by the Medicare benchmark ratio of 2.4, suggesting the facility's rates are well above the federal baseline. While commercial insurance plans like Blue Cross Blue Shield and Humana negotiate rates ranging from $116 to $425, many of these negotiated amounts exceed the cash price, particularly for plans with higher deductibles. In such cases, paying the full cash price of $425.00 upfront may be more cost-effective than relying on insurance reimbursement, which often results in lower net payments to the patient after deductibles and co-pays are applied.
Patients should proactively inquire about "prompt-pay" discounts, which can reduce the total bill by 20% to 50% if paid in full within a short window, such as 30 days. Since the facility is a Critical Access Hospital with a proprietary ownership structure, it may offer specific self-pay or prompt-pay incentives that are not automatically applied to insurance claims. It is crucial to request a waiver of insurance submission before scheduling to ensure the cash discount is honored rather than being overridden by an automatic claim submission. Additionally, because the facility is located in a rural area (Zip 67439), patients should verify their specific plan's allowed amount, as some commercial payers may have negotiated rates that are lower than the cash price, while others might result in balance billing if the