Diagnostic mammogram (both breasts)
Facility: Sheridan County Hospital
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $170
- Cash Discount Price: $234
- vs. Medicare Baseline: 1.08x 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 |
|---|---|---|
| Celtic Insurance | $142 | 90% |
| Blue Cross Blue Shield | $170 | 108% |
| UnitedHealthcare | $222 | 141% |
Consumer Guidance & Cost Commentary
For a diagnostic mammogram at Sheridan County Hospital in Hoxie, KS, the cash price is $234.00, which matches the facility's median paid amount. This rate is 110% of the Medicare benchmark of $156.98, indicating a markup consistent with commercial pricing structures where negotiated rates often exceed the true cost of care. While the facility is a Government-Local owned Critical Access Hospital, patients with high-deductible plans may find the cash price more affordable than the negotiated rates of $170.00 to $222.00 charged by major payers like UnitedHealthcare and Blue Cross Blue Shield, depending on their specific deductible status.
To potentially lower costs, patients should inquire about prompt-pay discounts, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing the administrative overhead of insurance claims. It is also important to request an itemized billing audit before paying, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Although the data does not provide specific county or state average comparisons for this procedure, understanding the difference between the gross charge, the Medicare rate, and the negotiated allowed amount is essential for avoiding balance billing and ensuring you are paying a fair price for your care.