Screening mammogram (both breasts)
Facility: Girard Medical Center
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $101
- Cash Discount Price: $173
- vs. Medicare Baseline: 0.80x 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 |
|---|---|---|
| Aetna | $101 - $504 | 80% |
| Medicare (plans) | $101 | 80% |
| UnitedHealthcare | $101 - $274 | 80% |
| Humana | $101 | 80% |
| Blue Cross Blue Shield | $101 - $161 | 80% |
| Ambetter / Centene | $101 | 80% |
| Kansas Superior Select-All Plans | $101 | 80% |
| Multiplan-All Plans | $266 | 211% |
| Uhhis-All Plans | $274 | 217% |
Consumer Guidance & Cost Commentary
For a screening mammogram at Girard Medical Center in Girard, KS, the facility's cash price of $173.00 is lower than the average negotiated rates charged by major insurers like Aetna, UnitedHealthcare, and Blue Cross Blue Shield, which range from $101 to $504. While the facility's cash rate is higher than the national median paid amount of $101.00, it remains below the gross chargemaster price of $288.00. Patients with high-deductible plans may find paying the cash price directly more cost-effective than relying on insurance, as the negotiated rates often exceed the cash amount. Additionally, patients should inquire about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can further lower the final cost.
This facility operates as a Critical Access Hospital with government ownership, and its pricing is benchmarked against the Medicare rate of $126.25, which serves as a scientifically validated baseline for healthcare costs. The facility's cash rate of $173.00 represents a markup of approximately 36% over the Medicare amount, aligning with fair pricing standards that typically range between 120% and 150% of the federal rate. If you receive a bill from this provider, ensure you request a detailed itemized statement to verify that all charges correspond to services actually rendered, as summary bills often obscure errors or unbundled codes. Remember that the No Surprises Act protects you from balance billing for out-of-network services at in-network facilities, so you should never feel pressured to pay unexpected differences immediately without first disputing the claim.