CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Kootenai Health

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $117
Cash Discount Price: $251
vs. Medicare Baseline: 0.93x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Kootenai Health is $117. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $251. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.93x the Medicare baseline. Located in 2003 Kootenai Health Way, Coeur D'Alene, ID.

Cash / Self-Pay

$251

Average discount available for prompt cash payment at this facility.

Insurance Median

$117

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: $251 (199%)

Insurance Median: $117 (93%)

Cash: $251 (199% of Medicare)

Ins. Median: $117 (93% 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
Coordinated Care Of Washington	$22 - $81	17%
Molina Healthcare Of Idaho	$22 - $124	17%
Molina Healthcare Of Washington	$22 - $81	17%
Magellan	$33 - $116	26%
Wellpoint	$33 - $116	26%
Blue Cross Blue Shield	$34 - $362	27%
Humana	$34 - $117	27%
Pacificsource	$34 - $274	27%
Premera	$34 - $207	27%
Regence Blue Shield Of Idaho	$34 - $117	27%
UnitedHealthcare	$34 - $302	27%
Aetna	$35 - $278	28%
Group Health/Kaiser	$47 - $423	37%
Mountain Health Co-Op	$260	206%
Cigna	$274 - $278	217%
Interwest Health	$285	226%
First Choice Health (Ameriben)	$286 - $290	227%

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 $251.
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 Kootenai Health 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.