Screening mammogram (both breasts)
Facility: Fredonia Regional Hospital
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $169
- Cash Discount Price: $187
- vs. Medicare Baseline: 1.34x 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 |
|---|---|---|
| Blue Cross Blue Shield | $93 - $161 | 74% |
| Aetna | $96 - $169 | 76% |
| UnitedHealthcare | $96 - $169 | 76% |
| Veterans Programs - All Plans | $96 | 76% |
| Meritain-All Plans | $169 | 134% |
| Reserve National-All Plans | $169 | 134% |
| Cigna | $169 | 134% |
Consumer Guidance & Cost Commentary
For a screening mammogram (both breasts) at Fredonia Regional Hospital in Fredonia, KS, the cash price is $187.00, which matches the facility's median negotiated rate of $169.00. While this facility is a Critical Access Hospital with government local ownership, the cash price is notably higher than the state average of $126.25, which is the Medicare benchmark for this procedure. Because the cash price exceeds the Medicare rate, patients with high-deductible plans may find paying out-of-pocket cheaper than using insurance, as the negotiated rate often includes administrative overhead that pushes the final cost above the true cost of care.
Patients should verify if "self-pay" or "prompt-pay" discounts are available before scheduling, as these upfront payment incentives can reduce the bill by 20% to 50%. It is important to request a waiver of insurance submission to avoid automatic claims processing, which would void any cash discount agreement. Additionally, since the No Surprises Act prohibits balance billing for emergency care and non-emergency services at in-network facilities, patients should review their itemized bill carefully to ensure no unexpected charges for out-of-network ancillary services appear.