CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Methodist Hospitals Inc

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $327
Cash Discount Price: $441
vs. Medicare Baseline: 2.08x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Methodist Hospitals Inc is $327. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $441. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 2.08x the Medicare baseline. Located in 600 Grant St, Gary, IN.

Cash / Self-Pay

$441

Average discount available for prompt cash payment at this facility.

Insurance Median

$327

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: $441 (281%)

Insurance Median: $327 (208%)

Cash: $441 (281% of Medicare)

Ins. Median: $327 (208% 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 208% of the Medicare baseline (a markup of 108%). 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	$102 - $466	65%
Blue Cross Blue Shield	$102 - $6,760	65%
Humana	$102 - $327	65%
Medicare (plans)	$102	65%
United Heathcare	$102	65%
Zing	$104	66%
Caresource Maketplace	$169	108%
UnitedHealthcare	$176 - $327	112%
Ambetter / Centene	$204	130%
Cigna	$242 - $263	154%
Caresource	$327	208%
Managed Health Services	$327	208%
Medicaid / KanCare	$327	208%
Physicians Health Plan Of Northern Indiana	$364	232%
Encore	$378 - $561	241%
Phcs	$428	273%
Siho	$441	281%
Sagamore	$454	289%
Multiplan	$460	293%
Magnacare	$486	310%
Hfn	$491 - $536	313%

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 $441.
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 Methodist Hospitals Inc 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.