Diagnostic mammogram (both breasts)
Facility: Clay County Medical Center
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $88
- Cash Discount Price: $207
- vs. Medicare Baseline: 0.56x 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 |
|---|---|---|
| Multiplan- All Plans | $47 - $306 | 30% |
| UnitedHealthcare | $60 - $306 | 38% |
| Health Partners - All Plans | $75 - $306 | 48% |
| Aetna | $86 - $300 | 55% |
| Wppa/Providrs Care- All Plans | $86 - $300 | 55% |
Consumer Guidance & Cost Commentary
For a diagnostic mammogram at Clay County Medical Center in Clay Center, KS, the cash price is $207.00, which matches the facility's median paid amount. This cash rate is significantly lower than the negotiated rates charged to insurance plans, which range from a low of $47 to a high of $306 across five payers. While the facility is a Critical Access Hospital with a government-local ownership structure, patients should be aware that commercial insurance contracts often result in higher out-of-pocket costs due to administrative overhead and multi-layered pricing structures. In cases where a patient has a high deductible or limited insurance coverage, paying the cash price directly can sometimes be more economical than relying on insurance, especially if the negotiated rate exceeds the cash price.
To ensure you are not overcharged, it is crucial to request an itemized billing audit before finalizing payment, as over 80% of hospital bills contain errors such as unbundled codes or services not rendered. Additionally, patients should inquire about "self-pay" or "prompt-pay" discounts, which can reduce the bill by 20% to 50% if paid in full upfront, bypassing the costly claims processing cycle. When comparing this facility's pricing to broader benchmarks, the Medicare amount for this service is $156.98, serving as a scientifically validated baseline for fair pricing. While the data does not provide specific state or county average comparisons for this exact code, understanding that commercial rates often average 200% to 300% of Medicare helps contextualize the facility's pricing relative to the true cost of care delivery.