CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Cleveland Clinic Indian River Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $169
  • Cash Discount Price: $319
  • vs. Medicare Baseline: 1.34x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Cleveland Clinic Indian River Hospital is $169. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $319. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.34x the Medicare baseline. Located in 1000 36Th St, Vero Beach, FL.
Cash / Self-Pay
$319

Average discount available for prompt cash payment at this facility.

Insurance Median
$169

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: $319 (253%)
Insurance Median: $169 (134%)
Cash: $319 (253% of Medicare)
Ins. Median: $169 (134% 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.

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 $29 - $565 23%
Avmed $36 - $219 29%
Blue Cross Blue Shield $36 - $408 29%
Careplus $36 - $169 29%
Magellan $36 - $424 29%
United $36 - $169 29%
Value Options $36 29%
Wellcare $36 - $169 29%
Freedom Health $38 - $169 30%
Independent Living Systems $38 - $178 30%
Wellmed $38 - $169 30%
Clear Spring Health $39 - $183 31%
Cigna $41 - $210 32%
Carelon Bh Strategies $169 134%
Humana $169 134%
Clarity Health $178 - $459 141%
The Legacy Companies $178 - $459 141%
Devoted Health $186 147%
National Provider Network $192 152%
Three Rivers $192 152%
Consociate Health $206 163%
Bmi $388 307%
Multiplan $565 448%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 36Th St, Vero Beach, FL 32960
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals