CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Mercyone Newton Medical Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $435
  • Cash Discount Price: $507
  • vs. Medicare Baseline: 3.45x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Mercyone Newton Medical Center is $435. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $507. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 3.45x the Medicare baseline. Located in 204 N 4Th Ave E, Newton, IA.
Cash / Self-Pay
$507

Average discount available for prompt cash payment at this facility.

Insurance Median
$435

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: $507 (402%)
Insurance Median: $435 (345%)
Cash: $507 (402% of Medicare)
Ins. Median: $435 (345% 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 345% of the Medicare baseline (a markup of 245%). 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
Aetna $82 - $665 65%
Blue Cross Blue Shield $82 65%
Medicare (plans) $82 - $85 65%
UnitedHealthcare $83 - $405 66%
Amish Hospital Aid $111 88%
Iowa Dept Of Public Health $115 91%
Iowa Total Care $116 92%
Medicaid / KanCare $117 - $118 93%
Oscar $118 93%
Centivo $120 95%
Ambetter / Centene $140 111%
Claimdoc $167 132%
Nova $167 132%
Geha $270 - $405 214%
Newton Correctional Facility $307 - $462 243%
Health Choices $357 - $536 283%
Medical Associates $357 - $536 283%
Health Partners $417 - $626 330%
Auxiant $435 - $653 345%
Cigna $435 - $653 345%
Health Alliance $435 - $653 345%
Medica $435 - $653 345%
Midlands $435 - $653 345%
Midlands Choice $435 - $653 345%
1199 National Benefit Fund $443 - $665 351%
Allied Benefit Systems $443 - $665 351%
Asr Health Benefits $443 - $665 351%
Christian Brother Services $443 - $665 351%
Coventry $443 - $665 351%
First Health $443 - $665 351%
Lucent Health $443 - $665 351%
Luminare Health $443 - $665 351%
Medical Mutual $443 - $665 351%
Meritain $443 - $665 351%
Trustmark Small Business Benefits $443 - $665 351%
Webtpa $443 - $665 351%
Crime Victim Assistance $473 - $710 375%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 204 N 4Th Ave E, Newton, IA 50208
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals