Screening mammogram (both breasts)
Facility: Hospital District #6 Patterson Health Center
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $149
- Cash Discount Price: $132
- vs. Medicare Baseline: 1.18x 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 | $116 - $122 | 92% |
| UnitedHealthcare | $148 - $165 | 117% |
| Providers Care (Wppa)-All Plans | $289 | 229% |
Consumer Guidance & Cost Commentary
For this screening mammogram procedure, the facility's cash price of $132.00 is lower than the median negotiated rate of $149.00 paid by UnitedHealthcare and Providers Care, though it remains slightly higher than the cash median of $132.00 reported for the region. Patients with high-deductible plans may find paying the cash price directly more cost-effective if their insurance allowed amount exceeds this figure, as the negotiated rate often includes administrative overhead that does not benefit the patient. It is important to note that while the facility is a Critical Access Hospital in Anthony, KS, the specific county or state average data was not provided in this report, so comparisons to broader regional pricing benchmarks are not available for this specific code.
To avoid unexpected costs, consumers should verify their specific plan's deductible status before scheduling, as paying the full negotiated rate may be required if the deductible has not been met. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% when paid upfront, bypassing the administrative costs associated with insurance claims. If a balance bill is received from an out-of-network provider at this in-network facility, the No Surprises Act generally protects patients from paying the difference between the provider's full charge and the insurance allowed amount for non-emergency services, so any surprise billing should be disputed immediately with the insurer.