Diagnostic mammogram (both breasts)
Facility: Cloud County Health Center
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $700
- Cash Discount Price: $516
- vs. Medicare Baseline: 4.46x 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 446% of the Medicare baseline (a markup of 346%). 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 |
|---|---|---|
| Aetna | $663 - $685 | 422% |
| Health Partners - All Plans | $700 | 446% |
| Mpi-All Plans | $700 | 446% |
| Pponext-All Plans | $700 | 446% |
Consumer Guidance & Cost Commentary
For the diagnostic mammogram of both breasts (CPT 77066) at Cloud County Health Center in Concordia, KS, the facility's negotiated rate of $700 aligns with the median paid amount across all four commercial payers, including Aetna, Health Partners, Mpi-All Plans, and Pponext-All Plans. This negotiated rate is significantly higher than the cash median of $516.00 and represents a 4.5x markup compared to the Medicare amount of $156.98. While commercial insurance contracts often create a ceiling rate that protects in-network members, these rates frequently exceed cash prices due to administrative overhead and contract dynamics. Patients with high-deductible plans or those who have met their deductible should consider paying the cash price of $516.00 directly, as this can result in substantial savings compared to the insurance negotiated rate.
To maximize potential savings, patients should proactively ask the facility about "self-pay" or "prompt-pay" discounts, which can reduce bills by 20% to 50% when paid upfront, bypassing costly insurance claims processing. It is also important to request a full itemized bill before finalizing payment, as summary bills may obscure errors or unbundled charges that could be disputed. While this specific service does not include county or state average comparisons in the provided data, the facility's pricing structure demonstrates the typical disparity between commercial negotiated rates and the federal Medicare benchmark, highlighting the value of understanding the true cost versus the listed insurance amount.