CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Elkhart General Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $437
  • Cash Discount Price: $474
  • vs. Medicare Baseline: 2.78x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Elkhart General Hospital is $437. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $474. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 2.78x the Medicare baseline. Located in 600 E Blvd, Elkhart, IN.
Cash / Self-Pay
$474

Average discount available for prompt cash payment at this facility.

Insurance Median
$437

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: $474 (302%)
Insurance Median: $437 (278%)
Cash: $474 (302% of Medicare)
Ins. Median: $437 (278% 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 278% of the Medicare baseline (a markup of 178%). 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
Mclaren (Mi $77 49%
UnitedHealthcare $77 - $490 49%
Blue Cross Blue Shield $85 - $327 54%
Aetna $143 - $494 91%
Humana $143 - $510 91%
Pace $143 91%
Devoted Healthcare $146 - $151 93%
Plain Church $215 - $583 137%
Caresource $229 - $948 146%
Mhs $258 - $948 164%
Mdwise $327 - $948 208%
Cha $437 - $569 278%
Immergrun $437 - $583 278%
Php $474 - $510 302%
Cigna $525 - $554 334%
Multiplan $525 334%
Signature $532 339%
Encore $539 343%
Heartland $729 464%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 600 E Blvd, Elkhart, IN 46514
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Acute Care Hospitals