CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Fredonia Regional Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $169
  • Cash Discount Price: $187
  • vs. Medicare Baseline: 1.08x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Fredonia Regional Hospital is $169. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $187. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.08x the Medicare baseline. Located in 1527 Madison, Fredonia, KS.
Cash / Self-Pay
$187

Average discount available for prompt cash payment at this facility.

Insurance Median
$169

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$156.98

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $156.98 (100%)
Cash / Self-Pay: $187 (119%)
Insurance Median: $169 (108%)
Cash: $187 (119% of Medicare)
Ins. Median: $169 (108% of 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.

Input your details and click calculate to compare out-of-pocket costs.

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 $93 - $123 59%
UnitedHealthcare $96 - $169 61%
Veterans Programs - All Plans $96 61%
Aetna $96 - $169 61%
Reserve National-All Plans $169 108%
Meritain-All Plans $169 108%
Cigna $169 108%

Consumer Guidance & Cost Commentary

For the diagnostic mammogram (both breasts) at Fredonia Regional Hospital in Fredonia, KS, the cash price is $187.00, which matches the facility's cash median. This rate is significantly higher than the Medicare benchmark of $156.98, reflecting a markup of 110% relative to the federal government's fixed reimbursement rate. While the facility is a Critical Access Hospital owned by the local government, patients with high-deductible plans may find the cash price more affordable than the negotiated rates paid by insurance carriers. Several payers, including UnitedHealthcare and Aetna, have negotiated rates ranging from $96 to $169, meaning the cash price could be lower than the amount your insurance would allow for this service.

To maximize savings, patients should proactively request "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the bill by 20% to 50% by bypassing costly insurance claims processing. It is important to avoid accepting summary bills that obscure individual charges; instead, demand a full itemized statement to identify any errors or unbundled codes, as over 80% of hospital bills contain inaccuracies. Additionally, while the No Surprises Act protects patients from balance billing for out-of-network services at in-network facilities, you should verify your specific plan's deductible status and allowed amounts before proceeding, as paying the full negotiated rate without meeting your deductible could result in higher out-of-pocket costs than paying the cash price directly.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1527 Madison, Fredonia, KS 66736
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals