CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Northwest Health - Porter

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $293
  • Cash Discount Price: $263
  • vs. Medicare Baseline: 2.32x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Northwest Health - Porter is $293. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $263. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.32x the Medicare baseline. Located in 85 East Us Hwy 6, Valparaiso, IN.
Cash / Self-Pay
$263

Average discount available for prompt cash payment at this facility.

Insurance Median
$293

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: $263 (208%)
Insurance Median: $293 (232%)
Cash: $263 (208% of Medicare)
Ins. Median: $293 (232% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 232% of the Medicare baseline (a markup of 132%). 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
UnitedHealthcare $74 - $270 59%
Tricare $78 62%
Veterans Eval Services $82 65%
Aetna $83 - $488 66%
Blue Cross Blue Shield $83 - $270 66%
Humana $83 - $270 66%
Medicare (plans) $83 - $89 66%
Node Mhs Mcr Adv $83 66%
Healthy Indiana Plan $84 67%
Node Devoted Health Mcr Adv $84 67%
Node Hospice Non Par Agree $84 67%
Node Va $84 67%
Care Improvement Plus $87 69%
In Dept Of Correction $88 70%
Indiana Dept Of Health Bccp $91 72%
One Call $118 93%
Align Network $135 107%
One Call Work Comp $135 107%
Encore Health $152 - $770 120%
Prime Health $152 - $722 120%
Indiana Work Comp $169 134%
Lutheran Preferred $169 - $577 134%
Managed Health Services $169 - $270 134%
Lutheran Preferred Chs Employees $177 - $231 140%
Self Pay $199 - $346 158%
Node Us Dept Of Labor $201 159%
Node Encore Kba Epo $203 161%
Porter County $203 161%
Preferred Network Access $203 161%
Cigna $205 - $267 162%
Magnacare Ma $215 170%
Encore Ppo $263 208%
Caresource $270 214%
Medicaid / KanCare $270 214%
Mhs $270 214%
Physicians Health Plan $282 - $369 223%
Php Freedom $304 - $397 241%
Sagamore Health Network $326 - $570 258%
First Health Coventry $361 - $471 286%
Southeastem Indiana Health Operations $516 - $722 409%
Network Synergy Group $553 - $722 438%
Multiplan/Phcs $619 - $808 490%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 85 East Us Hwy 6, Valparaiso, IN 46383
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals