CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Memorial Hospital and Manor

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $396
Cash Discount Price: $359
vs. Medicare Baseline: 3.14x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Memorial Hospital and Manor is $396. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $359. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 3.14x the Medicare baseline. Located in 1500 E Shotwell Street, Bainbridge, GA.

Cash / Self-Pay

$359

Average discount available for prompt cash payment at this facility.

Insurance Median

$396

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: $359 (284%)

Insurance Median: $396 (314%)

Cash: $359 (284% of Medicare)

Ins. Median: $396 (314% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 314% of the Medicare baseline (a markup of 214%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Tricare	$76	60%
Aetna	$81 - $462	64%
Humana	$81 - $410	64%
Medicare (plans)	$81	64%
Wellcare_Plan	$81	64%
Ambetter / Centene	$106	84%
Alliant_Plan	$130	103%
Amerigroup_Plan	$323	256%
Medicaid / KanCare	$323	256%
Peach_State_Health_Plan_Plan	$323	256%
Caresource_Plan	$339	269%
Blue Cross Blue Shield	$396	314%
Uhc_Plan	$405	321%
Novanet_Plan	$410	325%
Cigna	$426	337%
Private_Healthcare_Systems_Plan	$436	345%
Tnga_Plan	$450	356%
Multiplan_Plan	$462	366%
Corvel_Plan	$487	386%

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 $359.
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 Memorial Hospital and Manor 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.