CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Terre Haute Regional Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $137
Cash Discount Price: $1,056
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Terre Haute Regional Hospital is $137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,056. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.09x the Medicare baseline. Located in 3901 S Seventh St, Terre Haute, IN.

Cash / Self-Pay

$1,056

Average discount available for prompt cash payment at this facility.

Insurance Median

$137

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: $1,056 (836%)

Insurance Median: $137 (109%)

Cash: $1,056 (836% of Medicare)

Ins. Median: $137 (109% 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.

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
Humana	$82 - $85	65%
Blue Cross Blue Shield	$85 - $506	67%
In State Health (Bccp)	$85	67%
Mdwise Hoosier Alliance	$85 - $278	67%
United	$85 - $217	67%
United Behavioral Health	$85	67%
Vista Care Hospice	$85	67%
Centurion	$88	70%
American Health Plans	$92	73%
Ambulatory Care Solutions	$106	84%
Naphcare	$106	84%
American Correctional	$115	91%
Molina	$117 - $297	93%
Hospice Of Bloomington Hospital	$270	214%
Caresource	$276	219%

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 $1,056.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77067.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Terre Haute Regional Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77067.
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.