Screening mammogram (both breasts)
Facility: Smith County Memorial Hospital
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $162
- Cash Discount Price: $180
- vs. Medicare Baseline: 1.28x 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 |
|---|---|---|
| Medicaid / KanCare | $119 - $189 | 94% |
| Blue Cross Blue Shield | $122 | 97% |
| Multiplan-All Plans | $153 - $170 | 121% |
| Wppa-All Plans | $160 - $178 | 127% |
| Health Partners Of Ks Ppo-All Plans | $162 - $180 | 128% |
| Midlands Choice-All Plans | $162 - $180 | 128% |
| UnitedHealthcare | $162 - $180 | 128% |
Consumer Guidance & Cost Commentary
For the screening mammogram (both breasts) at Smith County Memorial Hospital in Smith Center, KS, the cash price is $180.00, which matches the facility's gross charge and the median cash rate reported for this service. While the hospital is a Critical Access Hospital owned by the local government, patients should be aware that paying cash upfront can sometimes result in lower out-of-pocket costs compared to using insurance, particularly if their plan has a high deductible. The facility offers a prompt-pay discount for those who settle the bill immediately, and patients are encouraged to explicitly request self-pay or prompt-pay rates before scheduling to avoid being billed the full negotiated amount by their insurer.
Insurance plans in this area negotiate rates that generally exceed the cash price, with allowed amounts ranging from $119 to $189 across seven payers, including Medicaid/KanCare and major PPOs like UnitedHealthcare and Blue Cross Blue Shield. The median negotiated rate is $162.00, which is slightly lower than the cash price but still represents a significant markup over the Medicare benchmark of $126.25. This pricing structure highlights the importance of understanding that in-network rates are not always the lowest possible; by comparing the facility's cash rate directly to the Medicare baseline, consumers can see that the commercial negotiated rates reflect administrative costs and contract dynamics rather than the true cost of care.