CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: HCA Florida Raulerson Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $127
Cash Discount Price: $1,185
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at HCA Florida Raulerson Hospital is $127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,185. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.01x the Medicare baseline. Located in 1796 Hwy 441 North, Okeechobee, FL.

Cash / Self-Pay

$1,185

Average discount available for prompt cash payment at this facility.

Insurance Median

$127

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: $1,185 (939%)

Insurance Median: $127 (101%)

Cash: $1,185 (939% of Medicare)

Ins. Median: $127 (101% 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
Humana	$84 - $474	67%
Careplus	$87	69%
Devoted Health	$87	69%
Ndms Definitive Care	$87	69%
United	$87 - $533	69%
Veterans Evaluation Services	$87	69%
Wellmed	$87	69%
Blue Cross Blue Shield	$89	70%
Ultimate Health Plan	$89	70%
Aetna	$90 - $356	71%
Prominence Healthfirst	$92	73%
Sunshine State	$92 - $96	73%
American Health Plan	$93	74%
Cigna	$93	74%
Florida Complete Care	$93	74%
Centurion	$96	76%
Freedom Health	$102 - $190	81%
Optimum	$102	81%
Amerihealth Caritas	$105	83%
Longevity Health Plan	$105	83%
Solis Health Plan	$127	101%
Avmed	$154 - $592	122%
Simply Healthcare Plans	$154	122%
Molina	$225 - $320	178%
Health Sun Health Plan	$252	200%
Sunshine State Health Plan	$302	239%
United Ppo	$521	413%
Plotkin Health	$592	469%
Prime Health Sherriff	$592	469%
Multiplan	$889 - $1,007	704%

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 $1,185.
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 HCA Florida Raulerson 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.