Screening mammogram (both breasts)
Facility: Golden Valley Memorial Hospital
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $37
- Cash Discount Price: $189
- vs. Medicare Baseline: 0.29x 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 |
|---|---|---|
| Aetna | $34 | 27% |
| Humana | $34 | 27% |
| UnitedHealthcare | $34 - $120 | 27% |
| Ambetter / Centene | $40 | 32% |
| Home State Health | $120 | 95% |
Consumer Guidance & Cost Commentary
For a screening mammogram at Golden Valley Memorial Hospital in Clinton, MO, the cash median price is $189. This rate is significantly lower than the facility's gross charge of $315 and the state average of $37 for the same service. While commercial insurance plans like UnitedHealthcare, Home State Health, and Aetna have negotiated rates as high as $120 or $34, patients with high-deductible plans may find paying the cash price of $189 upfront more economical if their insurance allowed amount exceeds this figure. The facility, owned by a Government Hospital District, lists a cash rate of $189, which is notably higher than the state average of $37 but represents a direct reduction from the gross charge of $315.
The Medicare amount for this procedure is $126.25, which serves as a key benchmark for understanding the true cost of care versus commercial markups. Although the facility has a 3-star rating and serves 5 payers, the data indicates that the median negotiated rate is $37, a figure that appears lower than the cash price but may not reflect the actual amount paid by patients after deductibles or co-pays are applied. Patients should be aware that while the No Surprises Act protects against balance billing for emergency care at in-network facilities, it is still critical to request a full itemized bill before paying to ensure no unbundled codes or services not rendered are included. Additionally, patients should explicitly ask the hospital about "prompt-pay" discounts or "self-pay" rates before scheduling, as these upfront discounts can further reduce the final cost compared to standard billing cycles.