CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: HSHS St Elizabeth's Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $624
  • Cash Discount Price: $562
  • vs. Medicare Baseline: 3.98x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at HSHS St Elizabeth's Hospital is $624. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $562. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 3.98x the Medicare baseline. Located in One St Elizabeth Boulevard, O Fallon, IL.
Cash / Self-Pay
$562

Average discount available for prompt cash payment at this facility.

Insurance Median
$624

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: $562 (358%)
Insurance Median: $624 (398%)
Cash: $562 (358% of Medicare)
Ins. Median: $624 (398% 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 398% of the Medicare baseline (a markup of 298%). 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
Molina Healthcare $43 - $781 27%
Meridian Health Plan $46 29%
Aetna $89 - $781 57%
Blue Cross Blue Shield $89 - $781 57%
Clear Spring Health Of Illinois $89 - $781 57%
Health Alliance Medical Plans $89 - $781 57%
Health Partners $89 - $781 57%
Humana $89 - $781 57%
UnitedHealthcare $89 - $781 57%
Sae Hospice $99 - $781 63%
Illinois Breast And Cervical Cancer Program $112 71%
Celtic Insurance Company $212 - $781 135%
Amish Community $219 140%
Naphcare $223 - $781 142%
Claim Doc $248 - $781 158%
Hopetrust $248 - $781 158%
Wellfirst $503 320%
First Health $581 370%
Cigna $617 - $781 393%
Healthlink $621 - $781 396%
Caterpillar, Inc. $627 399%
Consociate Group $687 438%
Choicecare $703 448%
Healthcare Finest Network (Hfn) $703 448%
Multiplan/Phcs $703 448%
Provider Network Of America $703 448%
City Of Springfield $781 498%
Current Health Solutions $781 498%
Healthscope $781 498%
Interplan $781 498%
Live360 $781 498%
Wexford $781 498%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One St Elizabeth Boulevard, O Fallon, IL 62269
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals