CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Ochsner Choctaw General

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $117
Cash Discount Price: $270
vs. Medicare Baseline: 0.93x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Ochsner Choctaw General is $117. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $270. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.93x the Medicare baseline. Located in 401 Vanity Fair Lane, Po Box 618, Butler, AL.

Cash / Self-Pay

$270

Average discount available for prompt cash payment at this facility.

Insurance Median

$117

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$126.25

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $126.25 (100%)

Cash / Self-Pay: $270 (214%)

Insurance Median: $117 (93%)

Cash: $270 (214% of Medicare)

Ins. Median: $117 (93% of 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.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Select Administrative Services Network	$63 - $248	50%
Claritev D/B/A Multiplan/Phcs/American Life Care	$68 - $266	54%
Medicaid / KanCare	$70 - $111	55%
Zelis	$76 - $266	60%
Cigna	$78 - $218	62%
Humana	$78 - $140	62%
Magnolia Health Plan – Wellcare By All Well Of Mississippi	$78 - $111	62%
Medicare (plans)	$78 - $128	62%
UnitedHealthcare	$78 - $155	62%
Ambetter / Centene	$79	63%
Shared Health Mississippi	$82 - $117	65%
Blue Cross Blue Shield	$104 - $156	82%
Prime Health Services Ppo	$128 - $284	101%
Prime Health Services Ppo -Workers Comp	$185 - $283	147%
Cor Vel	$187 - $289	148%
Aetna	$193 - $231	153%
Primewell Health Services Commercial Exchange Plan	$211 - $238	167%
Primewell Health Services – Commercial	$211 - $238	167%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $270.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77067.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ochsner Choctaw General is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77067.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.