Diagnostic mammogram (both breasts)
Facility: Regional Medical Center
Billing Code: 77066 (CPT)
- CPT Billing Code: 77066
- Insurance Median: $870
- Cash Discount Price: $488
- vs. Medicare Baseline: 5.54x 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.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 554% of the Medicare baseline (a markup of 454%). 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 |
|---|---|---|
| Medical Associates Health Plan - Tri | $870 | 554% |
Consumer Guidance & Cost Commentary
The cash price for a Diagnostic mammogram (both breasts) at Regional Medical Center in Manchester, IA, is $488. This facility, a Critical Access Hospital owned by the local government, lists its cash rate at $488, which is notably higher than the national average of $416. While the facility's negotiated rate for Medical Associates Health Plan - Tri is $870—significantly more than the cash price—patients with high-deductible plans might find the cash rate of $488 more affordable if their insurance allows. It is important to note that the Medicare amount for this service is $156.98, and the facility's rating is 4 out of 5 stars.
For a comprehensive understanding of your potential costs, it is crucial to distinguish between the gross charge of $610 and the actual negotiated or cash rates. Although the negotiated rate of $870 exceeds the cash price of $488, patients should be aware that balance billing is generally prohibited for emergency care and non-emergency services at in-network facilities under the No Surprises Act. If you encounter a surprise bill, you should request a formal itemized audit to identify any unbundled codes or services not rendered, as over 80% of hospital bills contain errors. Additionally, you may be entitled to a prompt-pay discount if you pay in full upfront, though this requires explicitly requesting a self-pay classification before check-in to avoid automatic claims submission that could void the discount.