CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Jeff Davis Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $495
  • Cash Discount Price: $265
  • vs. Medicare Baseline: 3.92x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Jeff Davis Hospital is $495. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $265. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 3.92x the Medicare baseline. Located in 163 South Tallahassee Street, Hazlehurst, GA.
Cash / Self-Pay
$265

Average discount available for prompt cash payment at this facility.

Insurance Median
$495

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: $265 (210%)
Insurance Median: $495 (392%)
Cash: $265 (210% of Medicare)
Ins. Median: $495 (392% 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 392% of the Medicare baseline (a markup of 292%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Medicaid / KanCare $113 - $443 90%
Humana $116 - $702 92%
Peach_State $116 - $164 92%
Wellcare $116 - $164 92%
Medicare (plans) $180 - $259 143%
Pen_Network $180 143%
Blue Cross Blue Shield $184 - $620 146%
Care_Improvement_Plus $184 - $261 146%
Coventry_Hmo $407 - $578 322%
Coventry_Pos $407 - $578 322%
Uhc_Hmo $436 - $620 345%
Uhc_Indemnity $436 - $620 345%
Uhc_Ppo $436 - $620 345%
Coventry_Ppo $448 - $636 355%
Beech_Street $466 - $661 369%
Care_Source $466 - $661 369%
Cigna $466 - $661 369%
One_Health_Ppo $466 - $661 369%
Choicecare $495 - $702 392%
Community_Care_Network $495 - $702 392%
Georgia_Hospital_Network $495 - $702 392%
Industry_Buying_Group $495 - $702 392%
Novanet $495 - $702 392%
Principal_Health_Care_Of_Georgia $495 - $702 392%
Three_Rivers_Provider_Network $495 - $702 392%
Usa_Managed_Care $495 - $702 392%
Memorial_Health_Partners $524 - $743 415%
Tricare $541 - $768 429%
Multiplan $553 - $785 438%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 163 South Tallahassee Street, Hazlehurst, GA 31539
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals