CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Franciscan Health Michigan City

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $414
Cash Discount Price: $194
vs. Medicare Baseline: 2.64x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Franciscan Health Michigan City is $414. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $194. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 2.64x the Medicare baseline. Located in 3500 Franciscan Way, Michigan City, IN.

Cash / Self-Pay

$194

Average discount available for prompt cash payment at this facility.

Insurance Median

$414

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: $194 (124%)

Insurance Median: $414 (264%)

Cash: $194 (124% of Medicare)

Ins. Median: $414 (264% 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 264% of the Medicare baseline (a markup of 164%). 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
Blue Cross Blue Shield	$102 - $621	65%
Medicare (plans)	$102 - $204	65%
Unicare [1150]	$204 - $409	130%
Workers Comp [1172]	$204 - $409	130%
Aetna	$260 - $520	166%
Managed Care [2000]	$260 - $1,051	166%
Mdwise [1175]	$327	208%
Medicaid / KanCare	$327 - $393	208%
Managed Health Services [1302]	$337	215%
Commercial [2001]	$372 - $927	237%
United Medical Resources [1158]	$372 - $744	237%
United Medical Resources [1301]	$372 - $827	237%
UnitedHealthcare	$372 - $827	237%
Cigna	$375 - $786	239%
Great West Insurance [1055]	$375 - $750	239%

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 $194.
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 Franciscan Health Michigan City 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.