CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: St Joseph Health System, LLC

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $270
  • Cash Discount Price: $326
  • vs. Medicare Baseline: 2.14x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at St Joseph Health System, LLC is $270. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $326. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.14x the Medicare baseline. Located in 702 Van Buren St., Fort Wayne, IN.
Cash / Self-Pay
$326

Average discount available for prompt cash payment at this facility.

Insurance Median
$270

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: $326 (258%)
Insurance Median: $270 (214%)
Cash: $326 (258% of Medicare)
Ins. Median: $270 (214% 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 214% of the Medicare baseline (a markup of 114%). 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%
Department Of Veterans Affairs $82 65%
Veterans Eval Services $82 65%
Aetna $83 - $561 66%
Blue Cross Blue Shield $83 - $299 66%
Humana $83 - $270 66%
Managed Health Services $83 - $270 66%
Medicare (plans) $83 66%
Node Devoted Health Mcr Adv $84 67%
Node Hospice Non Par Agree $84 67%
Node Va $84 67%
In Dept Of Correction $88 70%
Node Pphp Mcr Adv $89 70%
Spreemo $109 86%
Lutheran Advanced Network $127 101%
Lutheran Network $127 - $454 101%
Bccp In $128 101%
Encore Work Comp In $152 120%
Prime Health Services $152 - $619 120%
Lutheran Preferred $157 - $495 124%
Three Rivers $166 131%
Work Comp $169 134%
Amish Aid $198 157%
Self Pay $198 - $454 157%
Us Department Of Labor $201 159%
Encore Kba Epo $203 161%
Php $206 - $330 163%
Encore Kba Ppo $253 200%
Cigna $266 - $825 211%
Caresource $270 214%
Medicaid / KanCare $270 214%
Encore Ppo $272 - $742 215%
Php Freedom Network $366 290%
Sagamore $431 - $446 341%
Multiplan $569 - $644 451%
First Health $619 490%
Align Network $660 523%
Frontpath Health Coalition $660 523%
Advantage Health Solutions $685 543%
Allied Benefit Systems $742 588%
Medical Mutual Of Ohio $825 653%
Parkview Healthplan Services $825 653%
Value Options $825 653%

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