CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Presence St Marys Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $101
Cash Discount Price: $101
vs. Medicare Baseline: 0.64x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Presence St Marys Hospital is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $101. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 0.64x the Medicare baseline. Located in 500 W Court St, Kankakee, IL.

Cash / Self-Pay

$101

Average discount available for prompt cash payment at this facility.

Insurance Median

$101

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: $101 (64%)

Insurance Median: $101 (64%)

Cash: $101 (64% of Medicare)

Ins. Median: $101 (64% 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	$41 - $106	26%
Blue Cross Blue Shield	$41 - $142	26%
Countycare	$41	26%
Humana	$41 - $112	26%
Medicaid / KanCare	$41	26%
Meridian	$43 - $106	27%
Molina	$43 - $152	27%
Celtic (Wellcare)	$101	64%
Cigna	$101 - $841	64%
Clear Spring Health Of Illinois	$101	64%
Devoted Health	$101	64%
Essential Health Partners	$101 - $117	64%
Longevity Health Plan Of Illinois	$101	64%
Medicare (plans)	$101	64%
Ravenswood Physicians Associates Ipa	$101	64%
Resurrection Physicians Provider Group Ipa	$101	64%
Self-Pay	$101	64%
Tricare	$101	64%
United Behavioral Health	$101	64%
UnitedHealthcare	$101 - $127	64%
Village Md Chicago	$101	64%
Zing Health Provider Network	$104	66%
Provider Partners Health Plan (Pphp)	$106	68%
Access Community Health Network	$122	78%
Clifton Health System	$157	100%
Ambetter / Centene	$164	104%
Imagine Health Network, Inc.	$232	148%

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 $101.
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 Presence St Marys 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.