Diagnostic mammogram (both breasts)
Facility: Memorial Hospital
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $405
- Cash Discount Price: $737
- vs. Medicare Baseline: 2.58x 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 $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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 258% of the Medicare baseline (a markup of 158%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $130 | 83% |
| Tricare | $368 | 234% |
| Humana | $368 | 234% |
| Medicare (plans) | $372 | 237% |
| Ambetter / Centene | $405 | 258% |
| Coventry - All Other Plans | $663 | 422% |
| Preferred Healthcare-All Plans | $700 | 446% |
| Health Partners Of Kansas - All Plans | $700 | 446% |
| Wppa/Providers Care-All Plans | $1,031 | 657% |
Consumer Guidance & Cost Commentary
For a diagnostic mammogram at Memorial Hospital in Abilene, KS, the cash price is $737.00, which matches the facility's median negotiated rate of $405.00 for in-network payers like Ambetter/Centene and Tricare. While the facility is a Critical Access Hospital with a government ownership structure, the cash price remains significantly higher than the Medicare benchmark of $156.98, reflecting a markup of 2.6 times the federal rate. This pricing structure highlights that for patients with high-deductible plans, paying the full cash price of $737.00 upfront could be more cost-effective than relying on insurance, which may result in higher out-of-pocket costs if the deductible is not yet met or if the negotiated rate exceeds the cash price.
Patients should be aware that commercial insurance contracts often set a ceiling on what insurers will pay, which can sometimes be higher than the direct cash price due to administrative overheads and contract dynamics. To minimize costs, individuals should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront payment incentives can reduce the total amount owed. Furthermore, if a balance bill arises from an out-of-network ancillary service, consumers should verify the legality of the charge under the No Surprises Act and request a formal itemized audit to identify any unbundled codes or services not rendered, ensuring they are not paying for unnecessary fees.