CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Memorial Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $358
Cash Discount Price: $293
vs. Medicare Baseline: 2.28x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Memorial Hospital is $358. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $293. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 2.28x the Medicare baseline. Located in 4500 Memorial Drive, Belleville, IL.

Cash / Self-Pay

$293

Average discount available for prompt cash payment at this facility.

Insurance Median

$358

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: $293 (187%)

Insurance Median: $358 (228%)

Cash: $293 (187% of Medicare)

Ins. Median: $358 (228% 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 228% of the Medicare baseline (a markup of 128%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$105 - $366	67%
Humana	$107 - $338	68%
UnitedHealthcare	$107 - $363	68%
Cox Health [757]	$108	69%
Devoted Health Plan [847]	$108	69%
Essence Healthcare [221]	$108	69%
Medica [662]	$108	69%
Blue Cross Blue Shield	$112 - $425	71%
Healthscope Benefits [258]	$201	128%
Healthlink [225]	$237 - $368	151%
Cox Health Systems Insurance Company [220]	$268 - $317	171%
Health Alliance [224]	$268	171%
Allied Benefits [498]	$283 - $363	180%
Hope Trust [806]	$283	180%
Med-Pay [480]	$317 - $366	202%
Unicare [568]	$317 - $368	202%
Consociate [478]	$346	220%
Sarah Bush Lincoln [636]	$346	220%
Cigna	$347 - $386	221%
Coresource [497]	$358	228%
Fmh Benefit Service Inc [222]	$358	228%
Mail Handlers [495]	$358	228%
First Health Commercial [734]	$363	231%
Beechstreet [551]	$366	233%
Detego Health [868]	$366	233%
Health Systems Inc [620]	$366	233%
Healthcare Sol Mercy [609]	$366	233%
Multiplan Commercial [737]	$366	233%
Multiplan [240]	$366	233%
Phcs [244]	$366 - $390	233%
Preferred Health Professionals [561]	$368	234%
Apwu Health Plan [216]	$386	246%
Nalc Health Benefit Plan [242]	$386	246%
Priority Health [648]	$386	246%
Hfn [563]	$390	248%
Medica [661]	$390	248%

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 $293.
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 Memorial 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.