Diagnostic mammogram (both breasts)
Facility: Clara Barton Hospital
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $350
- Cash Discount Price: $284
- vs. Medicare Baseline: 2.23x 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 223% of the Medicare baseline (a markup of 123%). 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 | $122 | 78% |
| 6 Degrees Health - All Plans | $272 - $295 | 173% |
| Wppa-All Plans | $311 - $338 | 198% |
| UnitedHealthcare | $350 - $380 | 223% |
| Aetna | $350 - $380 | 223% |
| Phcs - All Plans | $350 - $380 | 223% |
| Hlth Partners Of Ks-All Plans | $358 - $388 | 228% |
Consumer Guidance & Cost Commentary
For a diagnostic mammogram at Clara Barton Hospital in Hoisington, KS, the cash price of $284.00 is lower than the facility's negotiated rates, which range from $272 to $388 depending on the insurance plan. While the facility's cash rate is competitive, patients with high-deductible plans might find it beneficial to pay the cash price directly, as this avoids the administrative fees and potential out-of-network balance billing that can occur with insurance claims. It is important to note that the facility's cash rate is significantly lower than the state average for this procedure, offering a clear financial advantage for those who can pay upfront.
The Medicare benchmark for this service is $156.98, which serves as a baseline for evaluating the facility's pricing structure. The facility's cash rate of $284.00 represents a markup relative to the Medicare amount, but it remains below the median negotiated rate of $350.00 paid by commercial payers. To ensure you receive the best possible price, we recommend contacting the hospital directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final cost. Additionally, if you have insurance, verify your specific plan's allowed amount before scheduling, as some commercial payers may negotiate rates higher than the cash price, potentially leading to unexpected balance billing if you are out-of-network.