Diagnostic mammogram (both breasts)
Facility: Decatur Health
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $419
- Cash Discount Price: $494
- vs. Medicare Baseline: 2.67x 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 267% of the Medicare baseline (a markup of 167%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $159 | 101% |
| Wppa/Providrs Care- All Plans | $329 | 210% |
| UnitedHealthcare | $335 - $419 | 213% |
| Humana | $338 | 215% |
| Midlands Choice- All Plans | $494 | 315% |
| Aetna | $494 - $549 | 315% |
| Medicaid / KanCare | $554 | 353% |
Consumer Guidance & Cost Commentary
For a diagnostic mammogram at Decatur Health in Oberlin, Kansas, the cash price is $494, which aligns with the state average for this procedure. While commercial insurance plans negotiate rates that typically range from $329 to $549 depending on the carrier, paying cash upfront can sometimes be more cost-effective for patients with high-deductible plans if their insurance negotiated rate exceeds the cash price. It is important to note that the facility's cash rate is lower than the gross charge of $549, and patients should explicitly ask about "self-pay" or "prompt-pay" discounts before scheduling to ensure they receive the lowest possible rate.
This service is benchmarked against the federal Medicare rate of $156.98, which serves as the objective baseline for evaluating hospital pricing markups. The facility's cash price represents a significant markup over the Medicare amount, a common dynamic where commercial rates reflect administrative costs and provider fees beyond the base reimbursement. To avoid unexpected costs, patients should request an itemized bill before paying, as summary invoices may obscure individual charges or unbundled services. Additionally, verifying your deductible status is crucial, as paying the negotiated rate without meeting your plan's deductible could result in higher out-of-pocket expenses than paying the cash price directly.