CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Ascension St Vincent's Clay County

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $105
Cash Discount Price: $272
vs. Medicare Baseline: 0.83x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Ascension St Vincent's Clay County is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $272. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.83x the Medicare baseline. Located in 1670 St Vincents Way, Middleburg, FL.

Cash / Self-Pay

$272

Average discount available for prompt cash payment at this facility.

Insurance Median

$105

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: $272 (215%)

Insurance Median: $105 (83%)

Cash: $272 (215% of Medicare)

Ins. Median: $105 (83% 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	$82 - $85	65%
Bc Advantage Mcr Replacement	$84	67%
Blue Cross Blue Shield	$84	67%
Community Hospice	$84	67%
Coventry Mcr Replacement Hmo	$84	67%
Haven Hospice	$84	67%
Medicare (plans)	$84 - $86	67%
Research Study Encore Borland-Groover	$84	67%
Veterans Administration	$84	67%
Wellcare	$84	67%
Cigna	$85 - $287	67%
UnitedHealthcare	$85 - $204	67%
Careplus Mcr Replacement	$86	68%
Aetna	$87 - $286	69%
Inmate Health Care	$105	83%
Bright Health	$114 - $122	90%
Smarthealth	$118	93%
Oscar Health Plan	$135	107%
Employer Direct Healthcare	$148	117%
90 Degree Benefits	$152	120%
Avmed Exchange	$152	120%
Molina Exchange	$156	124%
Occunet	$156 - $190	124%
Ambetter / Centene	$160	127%

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 $272.
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 Ascension St Vincent's Clay County 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.