CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Lutheran Hospital of Indiana

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $236
  • Cash Discount Price: $183
  • vs. Medicare Baseline: 1.87x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Lutheran Hospital of Indiana is $236. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $183. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.87x the Medicare baseline. Located in 7950 W Jefferson Blvd, Fort Wayne, IN.
Cash / Self-Pay
$183

Average discount available for prompt cash payment at this facility.

Insurance Median
$236

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: $183 (145%)
Insurance Median: $236 (187%)
Cash: $183 (145% of Medicare)
Ins. Median: $236 (187% 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.

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
UnitedHealthcare $74 - $270 59%
Tricare $78 62%
Department Of Veterans Affairs $82 65%
Veterans Eval Services $82 65%
Aetna $83 - $308 66%
Blue Cross Blue Shield $83 - $270 66%
Humana $83 - $270 66%
Iu Health Plan $83 66%
Managed Health Services $83 - $270 66%
Medicare (plans) $83 66%
Node Devoted Health Mcr Adv $84 67%
Node Hospice Non Par Agree $84 67%
Node Va $84 67%
In Dept Of Correction $88 70%
Node Pphp Mcr Adv $89 70%
Spreemo $109 86%
One Call Care Diagnostics $118 93%
Physicians Health Plan Of Northern Indiana $118 - $255 93%
Ky Work Comp $120 - $163 95%
Lutheran Advanced Network $127 101%
Node Lutheran Network $127 - $148 101%
Node Lutheran Preferred Fixed 2 $127 101%
Bccp In $128 101%
Align Network $135 107%
Amish Aid $143 - $194 113%
Lutheran Preferred Network $143 - $388 113%
Self Pay $143 - $233 113%
Encore Work Comp In $152 120%
Prime Health Services $152 - $485 120%
Cigna $154 - $235 122%
Lutheran Preferred $157 124%
Lutheran Network $169 - $324 134%
Us Department Of Labor $201 159%
Node Encore Kba Epo $203 161%
Sagamore $217 - $350 172%
Node Encore Kba Ppo $253 200%
Care Source $270 214%
Medicaid / KanCare $270 214%
Encore Ppo $272 215%
Multiplan $347 - $537 275%
Php Freedom Network $389 308%
Encore Health Network $390 - $582 309%
Advantage Health Solutions $395 - $537 313%
Allied Benefit Systems $428 - $582 339%
Evolutions $428 - $582 339%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 7950 W Jefferson Blvd, Fort Wayne, IN 46804
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals