CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: St Marys Good Samaritan Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $160
  • Cash Discount Price: $385
  • vs. Medicare Baseline: 1.02x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at St Marys Good Samaritan Hospital is $160. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $385. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.02x the Medicare baseline. Located in 5401 Lake Oconee Parkway, Greensboro, GA.
Cash / Self-Pay
$385

Average discount available for prompt cash payment at this facility.

Insurance Median
$160

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: $385 (245%)
Insurance Median: $160 (102%)
Cash: $385 (245% of Medicare)
Ins. Median: $160 (102% 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.

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
Blue Cross Blue Shield $115 - $428 73%
Peach State $152 97%
Wellcare $152 - $160 97%
Aetna $160 - $474 102%
Ambetter / Centene $160 102%
Care Improvement Plus $160 102%
Caresource $160 102%
Cigna $160 - $486 102%
Coventry $160 - $445 102%
Eon Health Plan $160 102%
Humana $160 - $445 102%
Kaiser Permanente $160 102%
Molina $160 102%
Pruitthealth Premier $160 102%
Todays Options Pffs $160 102%
Todays Options Ppo $160 102%
UnitedHealthcare $160 - $2,632 102%
Vaccn United $160 102%
First Health $445 283%
Phcs $445 283%
Meritain $474 302%
Multiplan $504 - $516 321%
Nova $504 - $534 321%
Three Rivers Provider Network $534 340%
Amerigroup $593 378%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5401 Lake Oconee Parkway, Greensboro, GA 30642
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Critical Access Hospitals