Screening mammogram (both breasts)
Facility: Clay County Medical Center
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $62
- Cash Discount Price: $194
- vs. Medicare Baseline: 0.49x 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 |
|---|---|---|
| Multiplan- All Plans | $36 - $306 | 29% |
| UnitedHealthcare | $45 - $306 | 36% |
| Aetna | $60 - $300 | 48% |
| Wppa/Providrs Care- All Plans | $60 - $300 | 48% |
| Health Partners - All Plans | $62 - $306 | 49% |
Consumer Guidance & Cost Commentary
For a screening mammogram at Clay County Medical Center in Clay Center, KS, the cash price is $194.00, which matches the facility's cash median. While the facility is a Critical Access Hospital owned by the local government, the negotiated rates for commercial payers range from $60 to $306, with a median negotiated amount of $62.00. This indicates that for patients with high-deductible plans, paying cash upfront may be more cost-effective than using insurance, as the negotiated rates often exceed the cash price. To secure the lowest possible cost, patients should explicitly request "self-pay" or "prompt-pay" discounts before scheduling, as these incentives can further reduce the final amount owed.
When evaluating the value of this service, it is important to compare the facility's rates against the Medicare benchmark rather than the hospital's gross chargemaster. The Medicare amount for this procedure is $126.25, and the facility's cash rate of $194.00 represents a markup of 0.5 times the Medicare rate. Although the data does not provide specific state or county average figures for comparison, the facility's cash price remains consistent with its own cash median. Consumers should be aware that commercial insurance contracts often result in higher out-of-pocket costs than cash payments due to administrative overhead and contract dynamics, making a direct comparison to the Medicare baseline the most reliable method for assessing fair pricing.