Screening mammogram (both breasts)
Facility: Susan B Allen Memorial Hospital
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $554
- Cash Discount Price: $136
- vs. Medicare Baseline: 4.39x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 439% of the Medicare baseline (a markup of 339%). 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 |
|---|---|---|
| UnitedHealthcare | $350 | 277% |
| Providrs Care | $757 | 600% |
Consumer Guidance & Cost Commentary
For a screening mammogram at Susan B Allen Memorial Hospital in El Dorado, KS, the cash price is $136.00, which is significantly lower than the facility's negotiated rates of $554.00 and the state average of $757.00. While the hospital's negotiated rates are higher than the cash price, patients with high-deductible plans might find the cash rate more beneficial if their insurance allowed amount exceeds $136.00. It is important to note that cash-pay options can sometimes result in lower out-of-pocket costs compared to insurance claims, provided the patient understands their specific deductible status and the allowed amount set by their carrier.
Patients should be aware that hospitals often offer prompt-pay discounts for self-pay patients who settle their bill upfront, which can further reduce the final cost. Additionally, if a patient receives care from an out-of-network provider at this in-network facility, they may face balance billing for the difference between the provider's full charge and the insurance payment, though the No Surprises Act protects against such surprise bills for emergency and non-emergency services. To ensure accuracy, consumers are encouraged to request a full itemized bill before paying, as summary invoices may obscure individual charges or unbundled services that should be reviewed for potential errors.