Screening mammogram (both breasts)
Facility: Trego County Lemke Memorial Hospital
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $204
- Cash Discount Price: $204
- vs. Medicare Baseline: 1.62x 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.
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 | 93% |
| Tricare | $127 | 101% |
| Medicaid / KanCare | $149 - $240 | 118% |
| Va Ccn - All Plans | $149 | 118% |
| Aetna | $149 - $216 | 118% |
| UnitedHealthcare | $149 - $240 | 118% |
| Ambetter / Centene | $164 | 130% |
| Blue Cross Blue Shield | $220 | 174% |
| Health Partners - All Plans | $228 | 181% |
| Healthy Blue Mcaid - All Plans | $240 | 190% |
Consumer Guidance & Cost Commentary
For the screening mammogram (both breasts) at Trego County Lemke Memorial Hospital in Wakeeney, KS, the facility's cash and negotiated rates are $204.00, which aligns with the median paid amount for this procedure. This rate is significantly higher than the Medicare benchmark of $126.25, reflecting a markup of 1.6 times the federal rate. While the facility is a Critical Access Hospital owned by the local government, patients should note that cash payments may sometimes be more cost-effective than using insurance if their plan's negotiated rate exceeds the cash price, as administrative fees and claim processing often inflate commercial rates.
The data shows a wide range of negotiated rates across payers, with Humana and Tricare paying $118 and $127 respectively, while UnitedHealthcare and Medicaid/KanCare plans range up to $240. Because the facility is in-network for most major payers, patients are protected from balance billing for this service under the No Surprises Act, meaning they will not be billed for the difference between the provider's chargemaster and the insurance allowed amount. However, to ensure the lowest possible cost, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before scheduling, as paying in full upfront can often bypass the higher administrative costs associated with insurance billing cycles.