CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Mercyone Waterloo Medical Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $232
Cash Discount Price: $304
vs. Medicare Baseline: 1.84x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Mercyone Waterloo Medical Center is $232. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $304. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.84x the Medicare baseline. Located in 3421 West Ninth Street, Waterloo, IA.

Cash / Self-Pay

$304

Average discount available for prompt cash payment at this facility.

Insurance Median

$232

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: $304 (241%)

Insurance Median: $232 (184%)

Cash: $304 (241% of Medicare)

Ins. Median: $232 (184% 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.

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
Health Choices	$77 - $143	61%
Medical Associates	$77 - $143	61%
Aetna	$82 - $492	65%
Blue Cross Blue Shield	$82	65%
Medicare (plans)	$82 - $85	65%
UnitedHealthcare	$83 - $607	66%
Amish Hospital Aid	$111	88%
Iowa Dept Of Public Health	$115	91%
Iowa Total Care	$116	92%
Medicaid / KanCare	$117 - $118	93%
Oscar	$128	101%
Centivo	$138	109%
Ambetter / Centene	$140	111%
Claimdoc	$167	132%
Nova	$167	132%
Geha	$211	167%
Health Partners	$215 - $398	170%
Auxiant	$232 - $431	184%
Cigna	$232 - $431	184%
Medica	$232 - $431	184%
Midlands	$232 - $431	184%
Midlands Choice	$232 - $431	184%
Allied Benefit Systems	$492	390%
Asr Health Benefits	$492	390%
Christian Brother Services	$492	390%
Coventry	$492	390%
First Health	$492	390%
Lucent Health	$492	390%
Luminare Health	$492	390%
Medical Mutual	$492	390%
Meritain	$492	390%
Webtpa	$492	390%

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 $304.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77067.

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 77067.
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.