CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: East Morgan County Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $147
Cash Discount Price: $185
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at East Morgan County Hospital is $147. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $185. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.16x the Medicare baseline. Located in 2400 W Edison St, Brush, CO.

Cash / Self-Pay

$185

Average discount available for prompt cash payment at this facility.

Insurance Median

$147

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: $185 (147%)

Insurance Median: $147 (116%)

Cash: $185 (147% of Medicare)

Ins. Median: $147 (116% 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
Pinnacol Assurance Workers Comp	$33 - $144	26%
Aetna	$34 - $317	27%
Banner Health	$34 - $147	27%
Blue Cross Blue Shield	$34 - $280	27%
Clear Spring Health	$34 - $147	27%
Healthspring Life & Health Insurance Company, Inc.	$34 - $147	27%
Medica	$34 - $284	27%
Medicare (plans)	$34 - $147	27%
Triwest Healthcare Alliance Corp - Va Ccn	$34 - $147	27%
UnitedHealthcare	$34 - $317	27%
Longevity	$35 - $151	28%
Humana	$36 - $155	29%
Devoted Health Services	$37 - $161	29%
Assist Health Group	$41 - $176	32%
Denver Health Medical Plan	$63 - $273	50%
Apostrophe, Inc.	$71 - $307	56%
First Choice Health Network	$71 - $307	56%
Hue Health, Inc	$75 - $324	59%
Rocky Mountain Health Plans	$75 - $324	59%
Multiplan	$77 - $331	61%

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 $185.
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 East Morgan County Hospital 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.