Diagnostic mammogram (both breasts)
Facility: St Luke Hospital & Living Center
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $120
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 0.76x 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 |
|---|---|---|
| UnitedHealthcare | $120 | 76% |
| Blue Cross Blue Shield | $120 | 76% |
| Bluestem Pace | $120 | 76% |
| Humana | $120 | 76% |
| Va Ccn | $120 | 76% |
| Kansas Department Of Health And Environment | $120 | 76% |
| Ambetter / Centene | $121 | 77% |
Consumer Guidance & Cost Commentary
For this diagnostic mammogram at St Luke Hospital & Living Center in Marion, KS, the facility's negotiated rate is $120, which aligns exactly with the lowest and highest rates reported across all seven payers, including UnitedHealthcare, Blue Cross Blue Shield, and Humana. This consistent pricing suggests a standardized contract structure rather than significant variation between insurance plans. While the facility is a Critical Access Hospital owned by a government hospital district, the data does not provide specific cash or median paid amounts for this service, so a direct comparison to state or county averages cannot be made based on the available figures. However, patients should note that cash-pay options can sometimes result in lower out-of-pocket costs if the insurance negotiated rate exceeds the cash price, particularly for those with high-deductible plans. It is always advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts before scheduling, as these upfront payment incentives can bypass the administrative costs associated with insurance billing cycles.
The Medicare benchmark for this procedure is $156.98, which serves as a reliable baseline for evaluating the facility's pricing markup. Commercial negotiated rates often range between 200% and 300% of Medicare amounts, though fair pricing is typically defined as 120% to 150% of the Medicare rate. In this specific case, the $120 negotiated rate is lower than the Medicare amount, indicating a favorable pricing structure compared to the federal government's cost-based reimbursement. Patients should be aware of balance billing protections, which prevent unexpected charges for out-of-network services at in-network facilities under the No Surprises Act. If a patient receives a bill that appears to include charges beyond the negotiated rate