CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Pocahontas Community Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $355
Cash Discount Price: $374
vs. Medicare Baseline: 2.26x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Pocahontas Community Hospital is $355. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $374. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 2.26x the Medicare baseline. Located in 606 N W 7Th Street, Pocahontas, IA.

Cash / Self-Pay

$374

Average discount available for prompt cash payment at this facility.

Insurance Median

$355

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: $374 (238%)

Insurance Median: $355 (226%)

Cash: $374 (238% of Medicare)

Ins. Median: $355 (226% 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 226% of the Medicare baseline (a markup of 126%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Molina	$187 - $374	119%
Iowa Total Care	$208 - $374	133%
Aetna	$224 - $374	143%
Blue Cross Blue Shield	$239 - $374	152%
Health Partners	$353 - $355	225%
Humana	$355 - $374	226%
Wellpoint	$355 - $374	226%
UnitedHealthcare	$359	229%
Cigna	$363	231%
Great West	$363	231%

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 $374.
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 Pocahontas Community Hospital 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.