CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Virginia Gay Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $243
Cash Discount Price: $436
vs. Medicare Baseline: 1.55x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Virginia Gay Hospital is $243. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $436. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.55x the Medicare baseline. Located in 502 North 9Th Avenue, Vinton, IA.

Cash / Self-Pay

$436

Average discount available for prompt cash payment at this facility.

Insurance Median

$243

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: $436 (278%)

Insurance Median: $243 (155%)

Cash: $436 (278% of Medicare)

Ins. Median: $243 (155% 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
Aetna	$142	90%
Medicaid / KanCare	$145 - $233	92%
UnitedHealthcare	$185 - $259	118%
Va Ccn-All Plans	$202	129%
Health Alliance Mcr Adv	$213	136%
Wellmark Hmo	$221	141%
Wellmark Ppo-All Other Plans	$243	155%
Medical Associates-All Plans	$409	261%
Cedar Valley Community Healthcare-All Plans	$429	273%
Humana	$436	278%
Health Partners-All Plans	$463	295%
Healthsmart-All Plans	$463	295%
Corvel-All Plans	$507	323%
Health Alliance-All Other Plans	$518	330%

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 $436.
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 Virginia Gay 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.