Diagnostic mammogram (both breasts)
Facility: William Newton Hospital
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $135
- Cash Discount Price: $376
- vs. Medicare Baseline: 0.86x 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.
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 | $117 - $135 | 75% |
| Triwest- All Plans | $131 | 83% |
| UnitedHealthcare | $135 - $339 | 86% |
| Ambetter / Centene | $135 - $376 | 86% |
| Providrs Care Nexus | $230 | 147% |
| Providrs Care - All Other Plans | $263 | 168% |
Consumer Guidance & Cost Commentary
For the diagnostic mammogram (both breasts) at William Newton Hospital in Winfield, Kansas, the cash price is $376.00, which matches the facility's gross charge and the median cash rate. While insurance plans like Blue Cross Blue Shield and Triwest-All Plans have negotiated rates starting as low as $117, these amounts are significantly lower than the cash price. However, for patients with high-deductible plans who have not yet met their out-of-pocket maximum, paying the cash price of $376.00 upfront can sometimes be more cost-effective than relying on insurance, which may result in a higher allowed amount or require the patient to cover the full negotiated rate before the deductible is satisfied.
The facility, a Critical Access Hospital owned by the local government, has a facility rating of 4 stars and a Medicare benchmark of $156.98. The median negotiated rate across all payers is $135.00, which is substantially lower than the cash price but higher than the Medicare benchmark. Because the cash price is equal to the gross charge, patients should explicitly ask the billing department about "self-pay" or "prompt-pay" discounts before scheduling, as these upfront fee reductions can lower the final cost. Additionally, if a patient receives care from an out-of-network provider at this in-network facility, they are protected by the No Surprises Act from balance billing for emergency and non-emergency services, though they should still request an itemized bill to verify that no unbundled codes or services not rendered have been charged.