CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Bob Wilson Memorial Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $231
  • Cash Discount Price: $113
  • vs. Medicare Baseline: 1.83x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Bob Wilson Memorial Hospital is $231. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $113. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.83x the Medicare baseline. Located in 415 N Main Street, Ulysses, KS.
Cash / Self-Pay
$113

Average discount available for prompt cash payment at this facility.

Insurance Median
$231

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$126.25

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $126.25 (100%)
Cash / Self-Pay: $113 (90%)
Insurance Median: $231 (183%)
Cash: $113 (90% of Medicare)
Ins. Median: $231 (183% of 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.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Medicare (plans) $90 71%
Humana $90 71%
Aetna $90 - $226 71%
Kansas Health $90 71%
UnitedHealthcare $90 - $235 71%
Centura Employee Plan $122 97%
Blue Cross Blue Shield $215 170%
Multiplan $254 - $262 201%
Health Partners Of Kansas $265 210%
Wppa $268 212%

Consumer Guidance & Cost Commentary

For a screening mammogram (both breasts) at Bob Wilson Memorial Hospital in Ulysses, KS, the facility's cash median price is $113.00, which is significantly lower than the state average of $231.00. While the hospital's negotiated rates with major payers like Aetna and UnitedHealthcare range from $90 to $235, patients with high-deductible plans may find paying the cash price upfront more cost-effective, as the cash rate is often lower than the insurance negotiated rate. It is important to note that cash payments can sometimes result in lower out-of-pocket costs if the patient's insurance allows a higher reimbursement than the cash price, making it a strategic option to verify with the billing department before scheduling.

The facility, a Critical Access Hospital owned by a voluntary non-profit church, lists its Medicare benchmark amount at $126.25, which serves as a reliable baseline for evaluating pricing fairness. The cash price of $113.00 is below this Medicare benchmark, suggesting a competitive rate structure compared to the federal standard. However, patients should be aware that commercial negotiated rates often include administrative overhead and contract dynamics that can inflate the final cost for insured members. To ensure the most accurate billing, consumers are encouraged to request an itemized bill before payment to verify all charges and avoid potential balance billing or errors, while also inquiring about prompt-pay discounts that could further reduce the total amount owed.

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 415 N Main Street, Ulysses, KS 67880
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals