Screening mammogram (both breasts)
Facility: Osborne County Memorial Hospital
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $212
- Cash Discount Price: $199
- vs. Medicare Baseline: 1.68x 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 |
|---|---|---|
| UnitedHealthcare | $176 - $180 | 139% |
| Health Partners Of Kansas | $200 - $204 | 158% |
| Wppa | $220 - $225 | 174% |
| Blue Cross Blue Shield | $227 - $232 | 180% |
Consumer Guidance & Cost Commentary
For a screening mammogram at Osborne County Memorial Hospital, the cash price of $199.00 is notably lower than the facility's negotiated rates with major payers, which range from $176 to $232 depending on the insurance plan. While the cash rate is lower than the facility's median negotiated amount of $212.00, patients with high-deductible plans may find paying out-of-pocket initially more cost-effective if their insurance allows a higher allowed amount than the cash price. It is important to note that the facility is a Critical Access Hospital in Osborne, Kansas, and while specific state or county average data was not provided in this report, patients should always verify their specific plan's allowed amount before scheduling to ensure they are not facing balance billing if they choose to use insurance.
Commercial insurance contracts often result in higher costs than cash payments due to administrative overhead and multi-layered pricing structures, which can inflate rates by 20% to 40% above the base cost. To minimize expenses, patients should explicitly ask the hospital about "self-pay" or "prompt-pay" discounts before check-in, as these upfront payment incentives can significantly reduce the final bill. If a patient chooses to use insurance, they should request a full itemized CPT-coded bill rather than accepting a summary invoice, as detailed statements allow for the identification of errors, unbundled codes, or services not rendered. Additionally, if any unexpected charges arise from out-of-network providers, patients should be aware of federal protections under the No Surprises Act that may prevent balance billing for emergency or non-emergency services at in-network facilities.