CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Davis County Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $339
  • Cash Discount Price: $616
  • vs. Medicare Baseline: 2.16x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Davis County Hospital is $339. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $616. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 2.16x the Medicare baseline. Located in 509 North Madison Street, Bloomfield, IA.
Cash / Self-Pay
$616

Average discount available for prompt cash payment at this facility.

Insurance Median
$339

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: $616 (392%)
Insurance Median: $339 (216%)
Cash: $616 (392% of Medicare)
Ins. Median: $339 (216% 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 216% of the Medicare baseline (a markup of 116%). 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
Blue Cross Blue Shield $58 - $64 37%
Aetna $308 196%
Choicecare Mcr Adv $333 212%
Home State Hlth Exch - All Other Plans $333 212%
Home State Hlth Mcr $333 212%
Mt Carmel Hp-All Plans $333 212%
Tricare $333 212%
Amerigroup Mcr Adv-All Other Plans $339 216%
American Hp Mcr Adv-All Plans $349 222%
Home State Hlth Mcaid $370 236%
Iowa Total Care Mcaid-All Plans $377 240%
Molina Mcaid-All Plans $383 244%
Amerigroup Mcaid $384 245%
Midlands Choice - All Plans $431 275%
Preferred Hlth Choices - All Plans $462 294%
Choicecare Comm - All Other Plans $585 373%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 509 North Madison Street, Bloomfield, IA 52537
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals