CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Iowa Specialty Hospital - Clarion

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $228
Cash Discount Price: $175
vs. Medicare Baseline: 1.45x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Iowa Specialty Hospital - Clarion is $228. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $175. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.45x the Medicare baseline. Located in 1316 South Main Street, Clarion, IA.

Cash / Self-Pay

$175

Average discount available for prompt cash payment at this facility.

Insurance Median

$228

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: $175 (111%)

Insurance Median: $228 (145%)

Cash: $175 (111% of Medicare)

Ins. Median: $228 (145% 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
Tricare	$44 - $228	28%
Triwest Va - All Plans	$44 - $228	28%
Aetna	$49 - $625	31%
Health Partners Ish-All Other Plans	$62 - $588	39%
Healthscope Stellar-All Plans	$73 - $388	47%
Wellmark Hmo	$94 - $208	60%
Wellmark Ppo - All Other Plans	$105 - $229	67%
UnitedHealthcare	$115 - $698	73%
Auxiant Clarion Schools-All Plans	$116 - $478	74%
Health Partners Prestage	$134 - $551	85%
Cigna	$347 - $713	221%
Midlands Choice-All Plans	$347 - $713	221%

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 $175.
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 Iowa Specialty Hospital - Clarion 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.