CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Goshen Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $139
  • Cash Discount Price: $385
  • vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Goshen Hospital is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $385. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 0.89x the Medicare baseline. Located in 200 High Park Ave, Goshen, IN.
Cash / Self-Pay
$385

Average discount available for prompt cash payment at this facility.

Insurance Median
$139

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: $385 (245%)
Insurance Median: $139 (89%)
Cash: $385 (245% of Medicare)
Ins. Median: $139 (89% 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.

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
Advantage Health Solutions $139 89%
Aetna $139 89%
Atrio Health Plans $139 89%
Bc Federal Employee $139 89%
Bc Mcr Advantage Ppo $139 89%
Blue Cross Blue Shield $139 89%
Buckeye Health Plan $139 89%
Cigna $139 89%
Coventry Health And Life $139 89%
Emblem Health $139 89%
Freedom Healthcare $139 89%
Geisinger Health Plan $139 89%
Health First $139 89%
Healthspring $139 89%
Humana $139 89%
Iehp Empire Health Plan $139 89%
Independent Care Health Plan $139 89%
Kaiser Permanente $139 89%
Mcr Advantra Freedom $139 89%
Mcr Allwell Mhs $139 89%
Mcr Banner Health $139 89%
Mcr Complete $139 89%
Mcr Complete Ppo $139 89%
Mcr Complete Wellmed $139 89%
Mcr Health Alliance $139 89%
Mcr Health Partners Plans $139 89%
Mcr Medical Mutual Of Ohio $139 89%
Mcr Passport Advantage $139 89%
Mcr Secure Horizons Ppo $139 89%
Mcr Texan Plus $139 89%
Mcr Upmc For Life $139 89%
Medicare (plans) $139 - $148 89%
Meridian Complete $139 89%
Optimum Healthcare $139 89%
Paramount Elite $139 89%
Primetime Health Plan $139 89%
Simply Complete Hmo $139 89%
The Umwa H&R Funds $139 89%
Todays Options Pyramid Life $139 89%
Trillium Advantage $139 89%
Ucare For Seniors $139 89%
Ucare Minnesota $139 89%
UnitedHealthcare $139 - $250 89%
Wellcare $139 89%
Champva $143 91%
Tricare $143 91%
Mcr Devoted Health Plan $148 94%
Mcr Provider Partners Hlth Pln $158 101%
Ambetter / Centene $201 128%
Mkt Caresource $201 128%
All Savers $250 159%
Golden Rule Insurance 2Nd $250 159%
Oxford Health $250 159%
Uhclic $250 159%
Uhss $250 159%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 High Park Ave, Goshen, IN 46526
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals