Screening mammogram (both breasts)
Facility: Regional Medical Center
Billing Code: 77067 (CPT)
- CPT Billing Code: 77067
- Insurance Median: $870
- Cash Discount Price: $322
- vs. Medicare Baseline: 6.89x 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 689% of the Medicare baseline (a markup of 589%). 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 | 689% |
Consumer Guidance & Cost Commentary
The cash price for a screening mammogram (both breasts) at the Regional Medical Center in Manchester, IA, is $322. This facility, a Critical Access Hospital owned by the local government, lists a negotiated rate of $870 with Medical Associates Health Plan - Tri, which is significantly higher than the cash option. While the facility's cash rate is lower than the state average of $403, patients with high-deductible plans may find the $322 cash price more beneficial than the $870 negotiated rate if their insurance deductible has not yet been met. It is essential to verify "self-pay" or "prompt-pay" discounts directly with the hospital before scheduling, as these upfront payment incentives can reduce the final cost even further.
For those utilizing Medicare, the allowed amount for this service is $126.25, which represents the federal government's baseline reimbursement rate. The facility's cash price of $322 exceeds the Medicare amount by 6.9 times, illustrating the markup between commercial and federal pricing standards. While the facility's cash rate is below the state average of $403, patients should be aware that commercial negotiated rates often average 200% to 300% of Medicare levels, whereas fair pricing is typically defined as 120% to 150% of Medicare. To ensure transparency and avoid unexpected charges, consumers are encouraged to request an itemized bill that details specific CPT codes rather than accepting broad summary invoices, and to dispute any errors in writing if the charges do not match the agreed-upon rates.