CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: St Marys Good Samaritan Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $117
  • Cash Discount Price: $215
  • vs. Medicare Baseline: 0.93x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at St Marys Good Samaritan Hospital is $117. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $215. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.93x the Medicare baseline. Located in 5401 Lake Oconee Parkway, Greensboro, GA.
Cash / Self-Pay
$215

Average discount available for prompt cash payment at this facility.

Insurance Median
$117

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: $215 (170%)
Insurance Median: $117 (93%)
Cash: $215 (170% of Medicare)
Ins. Median: $117 (93% 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
Blue Cross Blue Shield $61 - $250 48%
Aetna $86 - $277 68%
Ambetter / Centene $86 - $93 68%
Care Improvement Plus $86 - $93 68%
Caresource $86 - $93 68%
Cigna $86 - $284 68%
Coventry $86 - $260 68%
Eon Health Plan $86 - $93 68%
Humana $86 - $260 68%
Kaiser Permanente $86 - $93 68%
Molina $86 - $93 68%
Pruitthealth Premier $86 - $93 68%
Todays Options Pffs $86 - $93 68%
Todays Options Ppo $86 - $93 68%
UnitedHealthcare $86 - $2,632 68%
Vaccn United $86 - $93 68%
Wellcare $86 - $122 68%
Peach State $122 97%
First Health $238 - $260 189%
Phcs $238 - $260 189%
Meritain $254 - $277 201%
Multiplan $269 - $301 213%
Nova $269 - $311 213%
Three Rivers Provider Network $285 - $311 226%
Amerigroup $317 - $346 251%

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