CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: St Luke Hospital & Living Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $110
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 0.87x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at St Luke Hospital & Living Center is $110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.87x the Medicare baseline. Located in 535 South Freeborn, Marion, KS.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$110

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$126.25

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $126.25 (100%)
Insurance Median: $110 (87%)
Ins. Median: $110 (87% of 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.

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
Humana $110 87%
Blue Cross Blue Shield $110 87%
Va Ccn $110 87%
Kansas Department Of Health And Environment $110 87%
UnitedHealthcare $110 87%
Bluestem Pace $110 87%
Ambetter / Centene $111 88%

Consumer Guidance & Cost Commentary

For a screening mammogram at St Luke Hospital & Living Center in Marion, KS, the negotiated rate is $110, which matches the lowest and highest amounts paid by all seven commercial payers listed, including Humana and Blue Cross Blue Shield. This facility, a Critical Access Hospital owned by a government hospital district, does not offer a cash price or a median paid amount in the current data, meaning patients with high-deductible plans should verify if paying cash directly could result in a lower total than their insurance negotiated rate. While the facility's negotiated rate is fixed across all insurers, patients should explicitly ask for "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can significantly reduce the final bill by bypassing administrative processing costs.

The Medicare benchmark for this service is $126.25, which serves as the objective baseline for evaluating pricing fairness. Although the facility's negotiated rate of $110 is lower than the Medicare amount, patients should be aware that commercial rates often include administrative markups that can inflate the final cost compared to the true cost of care. To ensure you are not overpaying, it is crucial to request an itemized billing audit before paying any invoice, as summary bills often hide unbundled charges or services not rendered. If you receive a bill that appears inflated, you should dispute it in writing to the billing supervisor rather than accepting the summary total, ensuring you are only paying for the exact service rendered at the agreed-upon rate.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 535 South Freeborn, Marion, KS 66861
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals