CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Shenandoah Medical Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $110
Cash Discount Price: $213
vs. Medicare Baseline: 0.87x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Shenandoah Medical Center is $110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $213. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.87x the Medicare baseline. Located in 300 Pershing Avenue, Shenandoah, IA.

Cash / Self-Pay

$213

Average discount available for prompt cash payment at this facility.

Insurance Median

$110

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: $213 (169%)

Insurance Median: $110 (87%)

Cash: $213 (169% of Medicare)

Ins. Median: $110 (87% 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
Blue Cross Blue Shield	$68	54%
Home State Health Plan Mcaid-All Plans	$108	86%
Molina Mcd	$108	86%
Nebraska Total Care Mcaid-All Plans	$108	86%
UnitedHealthcare	$108 - $321	86%
Iowa Total Care Mcaid-All Plans	$109	86%
Amerigroup Mcaid-All Plans	$110	87%
Triwest Wellmark - All Plans	$110	87%
Aetna	$112 - $315	89%
Molina Mcr - All Other Plans	$112	89%
Tricare	$112	89%
Wellcare Mcr Adv - All Plans	$112	89%
Midlands Choice-All Plans	$305	242%

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 $213.
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 Shenandoah Medical Center 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.