CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Franklin General Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $188
Cash Discount Price: $336
vs. Medicare Baseline: 1.49x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Franklin General Hospital is $188. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $336. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.49x the Medicare baseline. Located in 1720 Central Avenue East, Hampton, IA.

Cash / Self-Pay

$336

Average discount available for prompt cash payment at this facility.

Insurance Median

$188

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: $336 (266%)

Insurance Median: $188 (149%)

Cash: $336 (266% of Medicare)

Ins. Median: $188 (149% 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
Medical Associates Mcare	$135 - $163	107%
Mount Carmel Hp-All Plans	$135 - $163	107%
Tricare	$135 - $163	107%
UnitedHealthcare	$135 - $339	107%
Amerigroup Mcare	$137 - $165	109%
Wellmark Mcr Adv	$137 - $165	109%
Ambetter / Centene	$141 - $261	112%
Molina Mcare	$141 - $170	112%
American Hp Iowa - All Plans	$142 - $171	112%
Amerigroup Mcaid - All Other Plans	$143 - $172	113%
Molina Mcaid - All Other Plans	$143 - $173	113%
Centivo - All Plans	$203 - $245	161%
Medical Ass Hosp Employer Group	$203 - $245	161%
Oscar - All Plans	$203 - $245	161%
Wellmark Hmo	$221	175%
Midlands Choice-All Plans	$237 - $286	188%
Wellmark Ppo - All Other Plans	$243	192%
Medical Associates Hp-All Other Plans	$287 - $347	227%
Preferred Health Choices-All Plans	$287 - $347	227%
Splashlight Llc-All Plans	$287 - $347	227%
Aetna	$314 - $388	249%
Multiplan-All Plans	$321 - $388	254%

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 $336.
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 Franklin General Hospital 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.