CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Decatur Memorial Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $408
  • Cash Discount Price: $887
  • vs. Medicare Baseline: 2.60x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Decatur Memorial Hospital is $408. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $887. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 2.60x the Medicare baseline. Located in 2300 North Edward Street, Decatur, IL.
Cash / Self-Pay
$887

Average discount available for prompt cash payment at this facility.

Insurance Median
$408

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: $887 (565%)
Insurance Median: $408 (260%)
Cash: $887 (565% of Medicare)
Ins. Median: $408 (260% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 260% of the Medicare baseline (a markup of 160%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Medicaid / KanCare $60 - $61 38%
Blue Cross Blue Shield $91 - $887 58%
Aetna $98 - $595 62%
Coventry $98 - $532 62%
Health Alliance $98 - $590 62%
Humana $98 - $577 62%
Medicare (plans) $98 - $146 62%
UnitedHealthcare $98 - $887 62%
Veterans Administration $98 - $146 62%
Wellcare $98 62%
Tricare $99 - $148 63%
Caterpillar $124 79%
Plain Church Medical Group $212 - $399 135%
Mennonite Churches $310 197%
Health Alliance Mh Employee Plan $408 260%
Cigna $413 263%
Hfn $444 - $665 283%
Commercial Workers Compensation $448 285%
Illinois Workers Compensation $472 301%
6 Degrees Health $532 339%
Hopetrust $532 339%
Hst $532 339%
Phcs Savility $577 368%
Phcs Multiplan Ppo $603 384%
Healthlink $608 387%
Corvel $639 407%
Consociate $656 418%
Liability $887 565%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2300 North Edward Street, Decatur, IL 62526
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals