CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Saint Joseph Regional Medical Center

Billing Code: 77066 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$174

about 1.1× the $157 Medicare rate · typically $121–$222

modeled estimate · not a bill or quote

What this hospital charges insurers

$204

Above the fair price

about $30 over the fair price · 1.3× Medicare

Medicare pays $157 Fair price $174 This hospital $204 Cash price $492 Hospital's list price $757

How we calculate the fair BaseRate →

How this hospital compares to other IN hospitals

Highest price of the 9 IN hospitals we have prices for — worth calling around.

Cheapest $45 Priciest $204

Black dot = this hospital, among the 9 IN hospitals with a price for this procedure. Full list below.

A fair price for a Diagnostic mammogram (both breasts) is about $174 (about 1.1× the $157 Medicare rate). Saint Joseph Regional Medical Center charges insurers about $204, or about $492 in cash — above the fair price. Located in Mishawaka, IN.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $174. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$60 - $327	38%
Blue Cross Blue Shieldmajor	$60 - $327	38%
Aetnamajor	$60 - $492	38%
Cignamajor	$484	308%
CareSource	$158	101%
GEHA	$315	201%
Health Net	$484 - $560	308%
HealthPartners	$484	308%
Medical Mutual	$492	313%
Meridian	$102	65%
MVP Health Care	$484	308%
Priority Health	$484	308%
+ 42 smaller / regional plans	$102 - $757

Government programs also on file: Medicare, Medicaid.

Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 492), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 77066.

Insurance Before you use insurance

Call your insurance company to confirm Saint Joseph Regional Medical Center is in-network.
Ask your insurer whether prior approval is required for CPT code 77066.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Saint Joseph Regional Medical Center

Compare: Diagnostic mammogram (both breasts) at other IN hospitals

Insurance negotiated median for the same procedure, sorted lowest first.