CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Phillips County Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $189
  • Cash Discount Price: $178
  • vs. Medicare Baseline: 1.20x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Phillips County Hospital is $189. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $178. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.20x the Medicare baseline. Located in 1150 State Street, Phillipsburg, KS.
Cash / Self-Pay
$178

Average discount available for prompt cash payment at this facility.

Insurance Median
$189

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$156.98

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $156.98 (100%)
Cash / Self-Pay: $178 (113%)
Insurance Median: $189 (120%)
Cash: $178 (113% of Medicare)
Ins. Median: $189 (120% of 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $123 - $169 78%
UnitedHealthcare $167 - $209 106%
Health Partners-All Plans $209 133%
Medicaid / KanCare $209 133%

Consumer Guidance & Cost Commentary

For the diagnostic mammogram of both breasts at Phillips County Hospital in Phillipsburg, KS, the facility's cash price of $178.00 is lower than the state average of $189.00, making it a potentially cost-effective option for self-pay patients. While the hospital's negotiated rates with major insurers like Blue Cross Blue Shield and UnitedHealthcare range from $123 to $209, these amounts often exceed the cash price, meaning patients with high-deductible plans might save money by paying directly. It is important to verify your specific plan's deductible status before scheduling, as paying the full negotiated rate without meeting your deductible can result in significant out-of-pocket costs. Additionally, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before check-in, as these upfront payment incentives can further reduce the final bill.

The facility's billing practices align with federal protections regarding surprise billing, particularly since the No Surprises Act bans balance billing for out-of-network providers at in-network facilities. However, patients should remain vigilant against summary bills that obscure individual charges; always request a full itemized statement to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors that can be corrected. When evaluating the cost, it is more accurate to compare the facility's rates against the Medicare benchmark of $156.98 rather than the inflated chargemaster list price of $209.00, which reveals the true cost basis for the procedure. By understanding these benchmarks and demanding itemized transparency, consumers can avoid unexpected financial burdens and ensure they are paying fair market value.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1150 State Street, Phillipsburg, KS 67661
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals