CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Mercyone Clinton Medical Center

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $583
  • Cash Discount Price: $433
  • vs. Medicare Baseline: 3.71x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Mercyone Clinton Medical Center is $583. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $433. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 3.71x the Medicare baseline. Located in 1410 North 4Th Street, Clinton, IA.
Cash / Self-Pay
$433

Average discount available for prompt cash payment at this facility.

Insurance Median
$583

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: $433 (276%)
Insurance Median: $583 (371%)
Cash: $433 (276% of Medicare)
Ins. Median: $583 (371% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 371% of the Medicare baseline (a markup of 271%). 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 $99 - $583 63%
Medicare (plans) $99 - $103 63%
Blue Cross Blue Shield $100 64%
UnitedHealthcare $101 - $666 64%
Amish Hospital Aid $134 85%
Oscar $138 88%
Iowa Dept Of Public Health $142 90%
Iowa Total Care $144 92%
Medicaid / KanCare $145 - $146 92%
Ambetter / Centene $169 108%
Health Choices $188 120%
Medical Associates $188 120%
Preferred Health Choice $192 122%
Claimdoc $203 129%
Nova $203 129%
Geha $255 162%
The Alliance $404 257%
1199 National Benefit Fund $583 371%
Allied Benefit Systems $583 371%
Asr Health Benefits $583 371%
Christian Brother Services $583 371%
Coventry $583 371%
First Health $583 371%
Lucent Health $583 371%
Luminare Health $583 371%
Medical Mutual $583 371%
Meritain $583 371%
Trustmark Small Business Benefits $583 371%
Webtpa $583 371%
Health Partners $584 372%
Auxiant $599 382%
Cigna $599 382%
Medica $599 382%
Midlands $599 382%
Midlands Choice $599 382%
Multiplan $599 382%
Qualcare $599 382%
Usa Managed Care $633 403%
Crime Victim Assistance $666 424%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1410 North 4Th Street, Clinton, IA 52732
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals