Diagnostic mammogram (both breasts)
Facility: Golden Valley Memorial Hospital
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $48
- Cash Discount Price: $213
- vs. Medicare Baseline: 0.31x 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 |
|---|---|---|
| Aetna | $44 | 28% |
| Humana | $44 | 28% |
| UnitedHealthcare | $44 - $149 | 28% |
| Ambetter / Centene | $52 | 33% |
| Home State Health | $149 | 95% |
Consumer Guidance & Cost Commentary
For this diagnostic mammogram procedure at Golden Valley Memorial Hospital in Clinton, MO, the cash median rate is $213, which is lower than the facility's gross charge of $355. While the facility's cash price is below the state average of $213, patients with high-deductible plans may find this cash rate more affordable than the commercial negotiated rates, which range from $44 to $149 depending on the insurance carrier. It is important to note that commercial rates can sometimes exceed cash prices due to administrative overhead and contract structures, so verifying the specific allowed amount for your plan before scheduling is essential.
Although the facility's cash rate matches the state average, patients should actively inquire about self-pay or prompt-pay discounts, which can reduce the final bill by 20% to 50% when paid upfront. If you choose to use insurance, be aware that balance billing is generally prohibited for out-of-network services at in-network facilities under the No Surprises Act, though summary bills may obscure individual line items; always request a full itemized CPT-coded bill to identify any unbundled charges or services not rendered. Additionally, since the facility's cash rate is equal to the state average, there is no immediate geographic pricing advantage, but securing a prompt-pay discount remains the most effective way to minimize costs for self-pay patients.