CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Boone County Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $195
Cash Discount Price: $305
vs. Medicare Baseline: 1.54x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Boone County Hospital is $195. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $305. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.54x the Medicare baseline. Located in 1015 Union Street, Boone, IA.

Cash / Self-Pay

$305

Average discount available for prompt cash payment at this facility.

Insurance Median

$195

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: $305 (242%)

Insurance Median: $195 (154%)

Cash: $305 (242% of Medicare)

Ins. Median: $195 (154% 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
Tricare	$117	93%
Choice Care Mcr Adv - All Plans	$136 - $178	108%
Humana	$136 - $390	108%
Iowa Hlth Adv - All Plans	$136 - $178	108%
Mt Carmel Hp - All Plans	$136 - $178	108%
UnitedHealthcare	$136 - $254	108%
Va Ccn-All Plans	$136 - $178	108%
Amerigroup Mcr Adv - All Other Plans	$137 - $179	109%
Aetna	$139 - $338	110%
Meridian Mcaid - All Plans	$149 - $195	118%
Iowa Total Care Mcaid - All Plans	$152 - $199	120%
Medicaid / KanCare	$153 - $201	121%
Wellmark Hmo	$201	159%
Wellmark Ppo - All Other Plans	$221	175%
Healthsmart Accell Network	$231 - $303	183%
Medical Associates Hp-All Plans	$248 - $325	196%
Healthsmart Ppo - All Other Plans	$264 - $346	209%
Health Alliance-All Plans	$298 - $390	236%
Midlands Choice-All Plans	$304 - $398	241%
Mutually Preferred-All Plans	$314 - $411	249%

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 $305.
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 Boone County 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.