CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Jacksonville Memorial Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $323
Cash Discount Price: $558
vs. Medicare Baseline: 2.56x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Jacksonville Memorial Hospital is $323. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $558. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.56x the Medicare baseline. Located in 1600 W Walnut St, Jacksonville, IL.

Cash / Self-Pay

$558

Average discount available for prompt cash payment at this facility.

Insurance Median

$323

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: $558 (442%)

Insurance Median: $323 (256%)

Cash: $558 (442% of Medicare)

Ins. Median: $323 (256% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 256% of the Medicare baseline (a markup of 156%). 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
Medicaid / KanCare	$47 - $94	37%
Molina Healthcare	$47 - $94	37%
Blue Cross Blue Shield	$55 - $578	44%
Coventry	$58 - $116	46%
Health Alliance	$58 - $393	46%
Humana	$58 - $493	46%
Medicare (plans)	$58 - $116	46%
Tricare	$58 - $116	46%
UnitedHealthcare	$61 - $416	48%
Illinois Workers Compensation	$152 - $308	120%
Health Alliance Mh Employee Plan	$247 - $266	196%
Commercial Workers Compensation	$272 - $292	215%
Corvel/Corcare	$280 - $301	222%
Current Health Network	$296 - $434	234%
6 Degrees Health	$323 - $347	256%
Hope Trust	$323 - $347	256%
Hst	$323 - $347	256%
Cigna	$373 - $401	295%
Aetna	$376 - $462	298%
Healthlink	$457 - $491	362%
Phcs/Multiplan	$484 - $520	383%
Hfn	$511 - $549	405%
Liability	$538 - $578	426%

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 $558.
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 Jacksonville Memorial Hospital 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.