CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: St Joseph Health System, LLC

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $327
  • Cash Discount Price: $369
  • vs. Medicare Baseline: 2.08x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at St Joseph Health System, LLC is $327. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $369. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 2.08x the Medicare baseline. Located in 702 Van Buren St., Fort Wayne, IN.
Cash / Self-Pay
$369

Average discount available for prompt cash payment at this facility.

Insurance Median
$327

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: $369 (235%)
Insurance Median: $327 (208%)
Cash: $369 (235% of Medicare)
Ins. Median: $327 (208% 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 208% of the Medicare baseline (a markup of 108%). 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 $90 - $327 57%
Tricare $95 61%
Department Of Veterans Affairs $100 64%
Veterans Eval Services $100 64%
Aetna $101 - $636 64%
Blue Cross Blue Shield $101 - $339 64%
Humana $101 - $327 64%
Managed Health Services $101 - $327 64%
Medicare (plans) $101 64%
Node Hospice Non Par Agree $102 65%
Node Va $102 65%
Node Devoted Health Mcr Adv $103 66%
In Dept Of Correction $106 68%
Node Pphp Mcr Adv $107 68%
Spreemo $131 83%
Lutheran Advanced Network $153 97%
Lutheran Network $153 - $514 97%
Bccp In $160 102%
Lutheran Preferred $163 - $561 104%
Three Rivers $172 110%
Encore Work Comp In $184 117%
Prime Health Services $184 - $701 117%
Work Comp $204 130%
Amish Aid $224 143%
Self Pay $224 - $514 143%
Php $234 - $374 149%
Encore Kba Epo $245 156%
Us Department Of Labor $249 159%
Encore Ppo $272 - $842 173%
Cigna $302 - $935 192%
Encore Kba Ppo $307 196%
Caresource $327 208%
Medicaid / KanCare $327 208%
Php Freedom Network $455 290%
Sagamore $488 - $506 311%
Multiplan $645 - $729 411%
First Health $701 447%
Align Network $748 476%
Frontpath Health Coalition $748 476%
Advantage Health Solutions $776 494%
Allied Benefit Systems $842 536%
Medical Mutual Of Ohio $935 596%
Parkview Healthplan Services $935 596%
Value Options $935 596%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 702 Van Buren St., Fort Wayne, IN 46802
  • CMS Rating: ★★★★☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals