Diagnostic mammogram (both breasts)
Facility: Hodgeman County Health Center
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $175
- Cash Discount Price: $199
- vs. Medicare Baseline: 1.11x 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 |
|---|---|---|
| Blue Cross Blue Shield | $117 - $123 | 75% |
| Humana | $159 | 101% |
| UnitedHealthcare | $159 - $237 | 101% |
| Triwest - All Plans | $159 | 101% |
| Medicaid / KanCare | $159 - $249 | 101% |
| Aetna | $199 | 127% |
| First Health - All Plans | $224 | 143% |
| Wppa (Provdrscare) - All Plans | $237 | 151% |
| Health Partners - All Plans | $237 | 151% |
Consumer Guidance & Cost Commentary
For the diagnostic mammogram (both breasts) at Hodgeman County Health Center in Jetmore, KS, the cash price is $199, which aligns closely with the state average of $199. While commercial insurance plans like Blue Cross Blue Shield and Humana negotiate rates ranging from $117 to $249, these negotiated amounts often exceed the cash price. Patients with high-deductible plans may find it financially advantageous to pay the cash rate of $199 directly, as the insurance negotiated rates for many carriers are higher than this amount. To maximize savings, it is recommended to contact the facility directly to inquire about "self-pay" or "prompt-pay" discounts, which can further reduce the final cost before any insurance processing occurs.
The Medicare benchmark for this service is $156.98, serving as the objective baseline for evaluating pricing markups. Although the cash rate of $199 is approximately 127% of the Medicare amount, commercial negotiated rates vary significantly, with UnitedHealthcare and Medicaid/KanCare plans showing ranges up to $249. It is important to note that comparing these rates to the hospital's gross charge of $249 can be misleading, as chargemasters are inflated to make discounts appear larger; the true value is found by comparing against the Medicare rate. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network providers at in-network facilities, patients should still verify their specific plan details and request an itemized bill to ensure no unexpected charges are included.