CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Mercyone Waterloo Medical Center

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $255
Cash Discount Price: $490
vs. Medicare Baseline: 1.62x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Mercyone Waterloo Medical Center is $255. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $490. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.62x the Medicare baseline. Located in 3421 West Ninth Street, Waterloo, IA.

Cash / Self-Pay

$490

Average discount available for prompt cash payment at this facility.

Insurance Median

$255

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: $490 (312%)

Insurance Median: $255 (162%)

Cash: $490 (312% of Medicare)

Ins. Median: $255 (162% 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.

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
Aetna	$99 - $608	63%
Medicare (plans)	$99 - $103	63%
Blue Cross Blue Shield	$100	64%
UnitedHealthcare	$101 - $754	64%
Amish Hospital Aid	$134	85%
Iowa Dept Of Public Health	$142	90%
Iowa Total Care	$144	92%
Medicaid / KanCare	$145 - $146	92%
Oscar	$155	99%
Centivo	$167	106%
Ambetter / Centene	$169	108%
Health Choices	$177	113%
Medical Associates	$177	113%
Claimdoc	$203	129%
Nova	$203	129%
Geha	$255	162%
Health Partners	$495	315%
Auxiant	$535	341%
Cigna	$535	341%
Medica	$535	341%
Midlands	$535	341%
Midlands Choice	$535	341%
Allied Benefit Systems	$608	387%
Asr Health Benefits	$608	387%
Christian Brother Services	$608	387%
Coventry	$608	387%
First Health	$608	387%
Lucent Health	$608	387%
Luminare Health	$608	387%
Medical Mutual	$608	387%
Meritain	$608	387%
Webtpa	$608	387%

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 $490.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77066.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Mercyone Waterloo Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77066.
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.