CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Cleveland Clinic Indian River Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $208
Cash Discount Price: $383
vs. Medicare Baseline: 1.33x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Cleveland Clinic Indian River Hospital is $208. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $383. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.33x the Medicare baseline. Located in 1000 36Th St, Vero Beach, FL.

Cash / Self-Pay

$383

Average discount available for prompt cash payment at this facility.

Insurance Median

$208

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$156.98

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $156.98 (100%)

Cash / Self-Pay: $383 (244%)

Insurance Median: $208 (133%)

Cash: $383 (244% of Medicare)

Ins. Median: $208 (133% of 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.

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
Aetna	$38 - $654	24%
Avmed	$46 - $254	29%
Blue Cross Blue Shield	$46 - $408	29%
Careplus	$46 - $208	29%
Magellan	$46 - $491	29%
United	$46 - $208	29%
Value Options	$46	29%
Wellcare	$46 - $208	29%
Freedom Health	$49 - $208	31%
Independent Living Systems	$49 - $218	31%
Wellmed	$49 - $208	31%
Clear Spring Health	$50 - $225	32%
Cigna	$54 - $254	34%
Carelon Bh Strategies	$208	133%
Humana	$208	133%
Devoted Health	$229	146%
Clarity Health	$235 - $532	150%
The Legacy Companies	$235 - $532	150%
National Provider Network	$253	161%
Three Rivers	$253	161%
Consociate Health	$271	173%
Bmi	$450	287%
Multiplan	$654	417%

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 $383.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77066.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Cleveland Clinic Indian River Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77066.
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.