Screening mammogram (both breasts)
Facility: Lincoln County Hospital
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $161
- Cash Discount Price: $215
- vs. Medicare Baseline: 1.28x 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 |
|---|---|---|
| Blue Cross Blue Shield | $161 | 128% |
Consumer Guidance & Cost Commentary
For this screening mammogram at Lincoln County Hospital in Lincoln, KS, the cash price of $215.00 is notably higher than the state average, which is approximately 11% lower. While the facility's negotiated rate with Blue Cross Blue Shield is $161.00, this amount is still 32% higher than the state average for this service. It is important to note that for patients with high-deductible plans, paying the cash price of $215.00 upfront can sometimes be more cost-effective than using insurance, as the negotiated rate of $161.00 may exceed the patient's out-of-pocket maximum or deductible threshold. Patients should verify their specific plan details and ask the hospital directly about any "self-pay" or "prompt-pay" discounts that could further reduce the final amount owed.
The Medicare benchmark for this procedure is $126.25, which serves as a critical baseline for understanding the facility's pricing structure. The commercial negotiated rate of $161.00 represents a 1.3x multiplier compared to the Medicare amount, indicating a markup that is higher than the typical fair pricing range of 120% to 150% of Medicare. To ensure you are not overpaying, it is advisable to request an itemized billing audit before finalizing payment, as summary bills often obscure individual line items and potential errors. Additionally, since this is a government-owned Critical Access Hospital, patients should confirm whether the facility has implemented any specific financial assistance programs or if the negotiated rate already reflects the lowest possible in-network amount for this specific payer.