Screening mammogram (both breasts)
Facility: Cloud County Health Center
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $341
- Cash Discount Price: $251
- vs. Medicare Baseline: 2.70x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 270% of the Medicare baseline (a markup of 170%). 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 | $301 - $621 | 238% |
| Health Partners - All Plans | $317 - $635 | 251% |
| Pponext-All Plans | $317 - $635 | 251% |
| Mpi-All Plans | $317 - $635 | 251% |
Consumer Guidance & Cost Commentary
For a screening mammogram at Cloud County Health Center in Concordia, KS, the facility's cash price is $251.00, which is lower than the state average of $341.00. While the facility's negotiated rate with major payers like Aetna and Health Partners is $341.00, patients with high-deductible plans may find the cash price more affordable if their insurance allows a higher amount than the cash rate. It is important to note that commercial negotiated rates often include administrative overhead and can exceed cash prices; therefore, patients should explicitly ask for "self-pay" or "prompt-pay" discounts before scheduling to ensure they are not charged the full negotiated amount.
This procedure is benchmarked against Medicare, which sets a fixed rate of $126.25 for this service. The facility's cash price of $251.00 represents a markup of 2.7 times the Medicare rate, which is consistent with the typical range where commercial rates fall between 200% and 300% of Medicare. If you receive a bill that exceeds the cash price or the Medicare benchmark, you should request an itemized billing audit to verify that no unbundled codes or services not rendered are included. Additionally, if you are out-of-network, the No Surprises Act may protect you from balance billing for emergency care or non-emergency services at in-network facilities, so you should dispute any unexpected charges rather than paying them immediately.