Diagnostic mammogram (both breasts)
Facility: Wamego Health Center
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $103
- Cash Discount Price: $229
- vs. Medicare Baseline: 0.66x 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 |
|---|---|---|
| UnitedHealthcare | $39 - $126 | 25% |
| Aetna | $40 - $131 | 25% |
| Medicaid / KanCare | $40 - $132 | 25% |
| Providrs Care | $64 - $207 | 41% |
| Ambetter / Centene | $103 | 66% |
| Blue Cross Blue Shield | $162 - $170 | 103% |
Consumer Guidance & Cost Commentary
For the diagnostic mammogram (both breasts) at Wamego Health Center, the cash median price is $229.00, which is significantly lower than the facility's negotiated rates with major payers like UnitedHealthcare (ranging from $39 to $126) and Aetna ($40 to $131). While the facility's negotiated rates appear higher than the cash price, patients with high-deductible plans should consider that paying cash upfront might be more cost-effective if their insurance allowed amount exceeds $229.00. It is crucial to verify your specific plan's deductible status before scheduling, as paying the full negotiated rate without meeting your deductible can result in higher out-of-pocket costs than paying the cash price directly. Additionally, patients should explicitly ask the facility about "self-pay" or "prompt-pay" discounts, which can reduce the final bill by 20% to 50% if paid in full before or shortly after the service.
When evaluating the cost of this procedure, it is important to compare rates against the Medicare benchmark rather than the hospital's gross charge list. The Medicare amount for this service is $156.98, and the facility's cash rate of $229.00 represents a markup of approximately 46% over the Medicare baseline, which aligns with fair pricing standards typically defined as 120% to 150% of the Medicare rate. Commercial negotiated rates often average 200% to 300% of the Medicare amount due to administrative overhead and contract dynamics, making the cash price a transparent and often superior option for self-pay patients. To ensure you are receiving the