Screening mammogram (both breasts)
Facility: Sheridan County Hospital
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $222
- Cash Discount Price: $234
- vs. Medicare Baseline: 1.76x 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 |
|---|---|---|
| Celtic Insurance | $142 | 112% |
| Blue Cross Blue Shield | $222 | 176% |
| UnitedHealthcare | $222 | 176% |
Consumer Guidance & Cost Commentary
For a screening mammogram at Sheridan County Hospital in Hoxie, KS, the cash price is $234.00, which matches the facility's median negotiated rate of $222.00 and the cash median. This service is significantly more expensive than the Medicare benchmark of $126.25, with a ratio of 1.8 times the Medicare amount. While the facility is a Critical Access Hospital owned by the local government, patients should be aware that cash payments can sometimes be more cost-effective than using insurance if the negotiated rate exceeds the cash price. Given that the cash price is already equal to the negotiated rate, patients with high-deductible plans may find paying out-of-pocket avoids additional administrative fees or potential balance billing scenarios, though they should verify if "self-pay" or "prompt-pay" discounts are available before scheduling.
This pricing data reflects the specific contract dynamics between the hospital and three major payers, including Celtic Insurance, Blue Cross Blue Shield, and UnitedHealthcare, all of which have a single plan at the $222.00 rate. Because the facility is in-network, the No Surprises Act generally protects patients from balance billing for emergency care and non-emergency services from out-of-network providers at this location. However, patients should still request a full itemized bill to ensure no unbundled codes or services not rendered are included, as summary bills can obscure individual charges. If a balance bill arises unexpectedly, patients should dispute it with their insurer rather than paying immediately, and they should avoid signing away their rights to out-of-network protections without fully understanding the terms.