CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Davis County Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $237
  • Cash Discount Price: $395
  • vs. Medicare Baseline: 1.88x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Davis County Hospital is $237. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $395. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.88x the Medicare baseline. Located in 509 North Madison Street, Bloomfield, IA.
Cash / Self-Pay
$395

Average discount available for prompt cash payment at this facility.

Insurance Median
$237

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: $395 (313%)
Insurance Median: $237 (188%)
Cash: $395 (313% of Medicare)
Ins. Median: $237 (188% 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.

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 46%
Aetna $158 - $237 125%
Choicecare Mcr Adv $171 - $256 135%
Home State Hlth Exch - All Other Plans $171 - $256 135%
Home State Hlth Mcr $171 - $256 135%
Mt Carmel Hp-All Plans $171 - $256 135%
Tricare $171 - $256 135%
Amerigroup Mcr Adv-All Other Plans $174 - $261 138%
American Hp Mcr Adv-All Plans $179 - $269 142%
Home State Hlth Mcaid $190 - $284 150%
Iowa Total Care Mcaid-All Plans $193 - $290 153%
Molina Mcaid-All Plans $196 - $294 155%
Amerigroup Mcaid $197 - $296 156%
Midlands Choice - All Plans $221 - $332 175%
Preferred Hlth Choices - All Plans $237 - $356 188%
Choicecare Comm - All Other Plans $300 - $450 238%

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