Screening mammogram (both breasts)
Facility: Kiowa County Memorial Hospital
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $205
- Cash Discount Price: $196
- vs. Medicare Baseline: 1.62x 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 |
|---|---|---|
| Blue Cross Blue Shield | $123 - $205 | 97% |
| UnitedHealthcare | $184 - $230 | 146% |
| Health Partners Of Ks-All Plans | $202 | 160% |
| Medica Prime Mcare Cost-All Plans | $205 | 162% |
| Aetna | $205 | 162% |
| Humana | $205 | 162% |
| Celtic Comml Exchange-All Other Plans | $205 | 162% |
| Medicaid / KanCare | $230 | 182% |
| Providrs Care/Wppa-All Plans | $345 | 273% |
Consumer Guidance & Cost Commentary
For the screening mammogram (both breasts) at Kiowa County Memorial Hospital in Greensburg, KS, the negotiated rates for in-network payers like Blue Cross Blue Shield and UnitedHealthcare range from $123 to $230, with a median negotiated amount of $205. This aligns closely with the facility's cash median of $196 and the median paid amount of $205, suggesting that for many patients, the insurance negotiated rate is comparable to or slightly higher than the cash price. While commercial rates often average 200% to 300% of Medicare, this specific service shows a negotiated rate of 160% of the Medicare benchmark of $126.25, which falls within the range typically considered fair pricing. Patients with high-deductible plans should note that paying the cash price of $196 upfront could result in lower out-of-pocket costs if their insurance allowed amount exceeds this figure, though they must verify their deductible status before scheduling to avoid unexpected balances.
The facility, a Critical Access Hospital owned by the local government, lists a gross charge of $230, but commercial contracts cap the billed amount significantly lower to protect members from full chargemaster rates. It is important to remember that in-network status does not guarantee the lowest possible price, as different insurers negotiate different ceilings; for instance, Medicaid/KanCare pays the full $230 while Blue Cross Blue Shield pays as low as $123. To potentially reduce costs further, patients should explicitly ask the hospital about self-pay or prompt-pay discounts, which can range from 20% to 50% off the billed amount for upfront payment.