Screening mammogram (both breasts)
Facility: Scott County Hospital
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $273
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 2.16x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 216% of the Medicare baseline (a markup of 116%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
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 | $72 - $288 | 57% |
| Humana | $127 | 101% |
| Blue Cross Blue Shield | $161 | 128% |
| Wppa | $182 - $1,200 | 144% |
| Aetna | $273 | 216% |
Consumer Guidance & Cost Commentary
For this screening mammogram at Scott County Hospital, the negotiated rates paid by major insurers range from $72 to $1,200, with a median negotiated amount of $273. This commercial rate is significantly higher than the Medicare benchmark of $126.25, reflecting the administrative costs and contract structures typical of in-network billing. While the facility is a Critical Access Hospital in Scott City, KS, and the data indicates a facility rating of 2, patients should be aware that cash-pay options are often more affordable. Since the cash median is not listed in this report, it is advisable to contact the hospital directly to inquire about self-pay or prompt-pay discounts, which can bypass the higher negotiated rates charged to insurance plans.
Patients should also be cautious regarding balance billing and itemized billing practices. Although the No Surprises Act protects against balance billing for out-of-network providers at in-network facilities, it is crucial to verify that all ancillary services, such as lab work or imaging, are covered under the same network agreement to avoid unexpected charges. If a summary bill is received, consumers should request a full itemized statement to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors that can be corrected through a formal written audit. By comparing the facility's rates against the Medicare benchmark and actively seeking cash discounts before scheduling, patients can ensure they are not paying unnecessarily high prices for this essential screening service.