Screening mammogram (both breasts)
Facility: Lindsborg Community Hospital
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $320
- Cash Discount Price: $251
- vs. Medicare Baseline: 2.53x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 253% of the Medicare baseline (a markup of 153%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 |
|---|---|---|
| Blue Cross Blue Shield | $122 | 97% |
| Tricare | $157 - $314 | 124% |
| Coventry Mcr Adv | $158 - $317 | 125% |
| Cigna | $284 - $568 | 225% |
| UnitedHealthcare | $301 - $601 | 238% |
| Coventry Comm-All Other Plans | $301 - $601 | 238% |
| Multiplan-All Plans | $311 - $621 | 246% |
| Phcs Preferred-All Plans | $311 - $621 | 246% |
| Wppa-All Plans | $317 - $635 | 251% |
| Health Partners -All Plans | $317 - $635 | 251% |
| Coventry Wc | $317 - $635 | 251% |
| Century Health-All Plans | $317 - $635 | 251% |
Consumer Guidance & Cost Commentary
For this screening mammogram at Lindsborg Community Hospital in Lindsborg, KS, the cash price is $251.00, which is lower than the facility's negotiated rates for most major payers. While the facility is a Critical Access Hospital with a voluntary non-profit ownership structure, patients with high-deductible plans may find paying cash directly more cost-effective than relying on insurance, as the negotiated rates for insurers like Cigna and UnitedHealthcare can exceed $600. To secure the lowest possible price, patients should explicitly ask the hospital for "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can significantly reduce the final bill by bypassing administrative claim processing fees.
The facility's cash rate of $251.00 is notably lower than the median negotiated amount of $317.00 and the median allowed amount of $320.00, suggesting that out-of-pocket payment could save money compared to standard insurance processing. However, patients must be aware of balance billing risks if they receive care from out-of-network providers, where the hospital could bill the difference between the full chargemaster rate and the insurance allowed amount. Under the No Surprises Act, balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities, but patients should still request an itemized CPT-coded bill to verify all charges and dispute any unbundled codes or services not rendered before agreeing to pay.