Screening mammogram (both breasts)
Facility: Ellsworth County Medical Center
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $140
- Cash Discount Price: $155
- vs. Medicare Baseline: 1.11x 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 |
|---|---|---|
| Humana | $73 - $147 | 58% |
| Healthy Blue Mcr Adv | $73 | 58% |
| Va Ccn-All Plans | $73 | 58% |
| Triwest -All Plans | $73 | 58% |
| UnitedHealthcare | $101 - $155 | 80% |
| Blue Cross Blue Shield | $116 - $122 | 92% |
| Aetna | $140 | 111% |
| First Health - All Plans | $140 | 111% |
| Cigna | $147 | 116% |
| Medicaid / KanCare | $155 | 123% |
| Coventry Mcaid-All Plans | $155 | 123% |
| Healthy Blue Mcaid- All Other Plans | $155 | 123% |
| Providers Care-Wppa-All Plans | $232 | 184% |
Consumer Guidance & Cost Commentary
For a screening mammogram (both breasts) at Ellsworth County Medical Center in Ellsworth, KS, the cash price is $155.00, which matches the facility's negotiated rate with Medicaid and several private insurers. While the facility's cash price is identical to the state average of $155.00, it is significantly higher than the county average of $120.00. If you have a high-deductible plan, paying the full cash price of $155.00 upfront might be more cost-effective than using insurance, as the negotiated rate for many commercial payers ranges from $116.00 to $155.00, meaning you could still owe the difference after your deductible is met. It is always advisable to ask the hospital directly about "self-pay" or "prompt-pay" discounts before scheduling, as these can reduce the final amount owed.
The facility's billing practices align with standard industry benchmarks, with a Medicare benchmarking ratio of 1.1, indicating the cash price is slightly above the federal baseline. However, the median amount paid by commercial insurers was $120.00, which is lower than the cash price, suggesting that for those with active coverage, insurance may result in a lower out-of-pocket cost depending on your deductible status. Since this is a Critical Access Hospital with a proprietary ownership structure, patients should request an itemized billing audit if they receive a summary bill, as over 80% of hospital bills contain errors such as double-billing or unbundled codes. Always verify your specific plan's allowed amount before the visit to avoid unexpected balance billing, though the No Surprises Act protects you