CPT77067

Screening Mammogram Cost in Kentucky

Scr mammo bi incl cad

$115.03Kentucky physician fee2026 Medicare office rate
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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Kentucky Medicare physician rate (2026)

-8.9% vs national

Single statewide locality.

Kentucky (Hospital)
$115.03
Facility physician fee
Private plan est.
$150–$230
~130–200% of Medicare
Cash / self-pay est.
$92–$173
~80–150% of Medicare

Your ZIP in Kentucky

Use a ZIP lookup for your area of Kentucky, whether Louisville, Lexington, the northern Kentucky suburbs of Cincinnati, Bowling Green, Owensboro, or the Appalachian east.

What screening mammogram costs at hospitals near you

Everything above is a national average. The hospital you pick in Kentucky moves the bill more than anything else you control.

Locked

Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

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What these numbers are

Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery centre rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again.

National vs Kentucky

National office$126.26
National hospital (physician)$126.26
Kentucky vs national9% below the national office rate of $126.26

Where Kentucky ranks for this CPT

Rank (lowest physician fee first)#5 of 51
Lowest stateArkansas ($111.36)
Highest stateDistrict of Columbia ($145.56)

Screening Mammogram and how Kentucky is priced

Kentucky's fee schedule runs on one statewide locality, with geographic indices below the national average, so Louisville, Lexington, and the Appalachian east all publish the same Medicare-approved amounts. The uniform locality smooths over a state with sharp internal contrasts, from urban river cities to some of the most rural counties in America. Because the adjustments are identical everywhere, the statewide figures here transfer cleanly to any Kentucky address. Setting of care, office versus hospital outpatient, remains the biggest driver of what a patient actually pays.

Louisville and Lexington host the state's two academic medical centers and absorb referrals from a wide rural hinterland, while northern Kentucky functions as part of the Cincinnati market across the river. Eastern Kentucky's mountain counties face persistent physician shortages and long travel for specialty procedures. For residents along the borders, comparing against Cincinnati, Nashville, or Huntington providers is often worthwhile.

This procedure: A screening bilateral mammogram is the routine X-ray check of both breasts in women with no symptoms, looking for cancers too small to feel. A technologist takes two standard views of each breast with brief compression; the visit takes about 20 minutes, and a radiologist reads the images afterward, with results sent within days. It is the test guidelines recommend at regular intervals starting in a woman's 40s.

What Is Screening Mammogram?

A screening bilateral mammogram is the routine X-ray check of both breasts in women with no symptoms, looking for cancers too small to feel. A technologist takes two standard views of each breast with brief compression; the visit takes about 20 minutes, and a radiologist reads the images afterward, with results sent within days. It is the test guidelines recommend at regular intervals starting in a woman's 40s.

What Affects the Cost

  • The screening itself is free under ACA preventive rules at in-network facilities, so out-of-pocket cost usually arises only from what follows.
  • 3D tomosynthesis screening is an add-on code; most plans and Medicare now cover it as part of screening, but a few still pass its cost to patients.
  • Callbacks for additional views are billed as diagnostic mammography with normal cost sharing, and roughly one in ten screenings generates a callback.
  • Out-of-network facilities are not bound by the zero-cost-share screening rule.
  • Dense-breast supplemental imaging, like ultrasound or MRI, is billed separately and often with cost sharing.

Questions to Ask Before Booking

  • 1.Is this facility in network so my screening is fully free?
  • 2.Is 3D tomosynthesis included at no charge under my plan?
  • 3.If I get called back for more views, what will that diagnostic visit cost me?
  • 4.Am I inside my plan's allowed screening interval so the claim will not be denied for timing?
  • 5.If I have dense breasts, what supplemental imaging might be recommended and does my plan cover it?

Screening Mammogram in Kentucky: questions

Kentucky is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 77067 is $115.03 in an office and $115.03 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.

Not on the physician fee schedule. Kentucky uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $23 for the office physician line or $23 for the hospital physician line in Kentucky. Medigap may cover that 20%. This is not the hospital facility fee.

No. $115.03 is the Medicare physician allowed amount for CPT 77067. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. Kentucky ranks #5 of 51 states on this physician line (9% below the national office rate of $126.26).

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.