Diagnostic mammogram (both breasts)
Facility: Trego County Lemke Memorial Hospital
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $169
- Cash Discount Price: $204
- vs. Medicare Baseline: 1.08x 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.
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 |
|---|---|---|
| Humana | $118 | 75% |
| Tricare | $127 | 81% |
| Medicaid / KanCare | $149 - $240 | 95% |
| UnitedHealthcare | $149 - $240 | 95% |
| Aetna | $149 - $216 | 95% |
| Va Ccn - All Plans | $149 | 95% |
| Ambetter / Centene | $164 | 104% |
| Blue Cross Blue Shield | $168 | 107% |
| Health Partners - All Plans | $228 | 145% |
| Healthy Blue Mcaid - All Plans | $240 | 153% |
Consumer Guidance & Cost Commentary
For the diagnostic mammogram (both breasts) at Trego County Lemke Memorial Hospital, the cash price of $204.00 is lower than the median negotiated rate of $169.00 paid by most insurance plans, including Humana, Tricare, and UnitedHealthcare. This price transparency data indicates that patients with high-deductible plans or those without insurance may save money by paying the cash price directly, as the facility's cash rate is below the average amount insurers agree to pay. However, patients should verify if their specific plan has a lower allowed amount, as some commercial payers may negotiate rates that fall below the cash price. Additionally, patients should inquire about "self-pay" or "prompt-pay" discounts before scheduling, as hospitals often offer further reductions for upfront payment to bypass administrative billing costs.
The facility's pricing is benchmarked against the Medicare rate of $156.98, which serves as a scientifically validated baseline for healthcare costs. While the cash price of $204.00 exceeds the Medicare amount, it remains below the gross chargemaster rate of $240.00 and is comparable to the negotiated rates of several major payers. It is important to note that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act, meaning patients should not expect to be billed for the difference between the provider's full list price and their insurance allowed amount for routine services. To ensure accuracy, patients should request an itemized bill to review specific CPT codes and avoid paying for services that were not rendered or that were incorrectly bundled.