CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Saint Joseph Regional Medical Center

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $327
  • Cash Discount Price: $492
  • vs. Medicare Baseline: 2.08x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Saint Joseph Regional Medical Center is $327. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $492. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 2.08x the Medicare baseline. Located in 5215 Holy Cross Pkwy, Mishawaka, IN.
Cash / Self-Pay
$492

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: $492 (313%)
Insurance Median: $327 (208%)
Cash: $492 (313% 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.

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
Aetna $60 - $492 38%
Blue Cross Blue Shield $60 - $327 38%
Medicaid / KanCare $60 - $327 38%
UnitedHealthcare $60 - $327 38%
Medicare (plans) $102 - $104 65%
Meridian Complete $102 65%
Pace-Trinity Health $102 65%
County Coroner $106 68%
Provider Partners Health Plan Of Indiana $112 71%
Auxiant $153 - $628 97%
Physicians Health Plan Northern Indiana Health Insurance $153 - $309 97%
St Joseph County Hlth Dpt $153 97%
Caresource $158 101%
Siho Insurance Services $164 104%
Key Benefit Administrator $184 - $471 117%
Allied Benefit Systems $194 - $492 124%
Hospice Of Marshall County $197 125%
Hospice Of St Joseph County $197 125%
Blue Benefit Administrators Of Massachusetts $204 130%
Blue Care Network $204 130%
Blue Distinction Transplant $204 130%
Blue Shield - Ca $204 130%
Blue Shield - Id (Regence) $204 130%
Blue Shield - Ny Highmark Northeastern $204 130%
Blue Shield - Ny Highmark Western $204 130%
Blue Shield - Pa (Highmark) $204 130%
Blue Shield - Wa (Regence) $204 130%
Plain Church Group $204 130%
Custom Design Benefits $220 140%
Geha $315 201%
Healthscope $315 201%
Student Insurance Cma $315 201%
Managed Health Services - Indiana $327 208%
Mdwise $327 208%
Notre Dame Athletic Association $416 265%
Wc Notre Dame $416 265%
Luminare Health (Detroit) $431 - $454 275%
Encore Health $449 - $471 286%
Ameriben $454 289%
Indiana Criminal Justice Inst $471 300%
Western & Southern Financial Group $471 300%
Cigna $484 308%
Group Administrators $484 308%
Health Partners $484 308%
Mvp $484 308%
Prairie States $484 308%
Priority Health $484 308%
Professional Benefit Administrators $484 308%
Sagamore Health Network $484 - $560 308%
Sisco Benefits $484 308%
Unified Group Services $484 308%
Asr Health Benefits $492 313%
Christian Brother Services $492 313%
Employee Benefit Management $492 313%
Medical Mutual $492 313%
Meritain $492 313%
Preferred One $492 313%
Rural Carrier Health Benefit Plan $492 313%
Webtpa $492 313%
Goshen Preferred Network $583 - $651 371%
Christian Brothers Holy Cross $606 386%
Signature Care $606 386%
Bankers Life Casualty $757 482%
Bureau Of Disability $757 482%
Wc Align Network $757 482%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5215 Holy Cross Pkwy, Mishawaka, IN 46545
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals