Diagnostic mammogram (both breasts)
Facility: Hiawatha Community Hospital
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $301
- Cash Discount Price: $386
- vs. Medicare Baseline: 1.92x 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.
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 | $117 - $123 | 75% |
| UnitedHealthcare | $143 - $332 | 91% |
| Aetna | $143 - $312 | 91% |
| Humana | $144 | 92% |
| Ambetter / Centene | $171 | 109% |
| Oscar - All Plans | $290 | 185% |
| Centrus Health Direct - All Plans | $290 | 185% |
| Preferred Hlth - All Plans | $347 | 221% |
| Cigna | $367 | 234% |
| Wppa Providrs Care - All Plans | $367 | 234% |
| Multiplan - All Plans | $374 | 238% |
| Midlands Choice - All Plans | $374 | 238% |
| Healthy Blue Mcaid - All Plans | $386 | 246% |
Consumer Guidance & Cost Commentary
For the diagnostic mammogram (both breasts) at Hiawatha Community Hospital in Hiawatha, KS, the cash price is $386.00, which matches the facility's gross charge and the state median. While the facility is a Critical Access Hospital with a voluntary non-profit ownership, patients should note that commercial insurance negotiated rates vary significantly by plan. For example, Blue Cross Blue Shield plans pay a low of $117, whereas Cigna and WPPA Providers Care pay $367. This disparity highlights that being "in-network" does not guarantee the lowest possible price, as some commercial contracts exceed the cash-pay amount. Additionally, the Medicare benchmark of $156.98 serves as a cost baseline; commercial rates here range from roughly 2.3 to 2.4 times the Medicare amount, indicating that the negotiated rates for many payers are well above the fair pricing range of 120% to 150% of Medicare.
To optimize costs, patients should verify if their specific insurance plan has a negotiated rate lower than the $386.00 cash price, as paying out-of-pocket might be more economical if the deductible is high or the insurance allowed amount is low. It is also advisable to ask the billing department about "self-pay" or "prompt-pay" discounts, which can reduce the total bill by 20% to 50% for upfront payment. If you receive a summary bill, request a full itemized statement to ensure no unbundled codes or services not rendered are included, as over 80% of hospital bills contain errors. Finally, be aware that while the No Surprises Act protects against balance billing