CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Saint Joseph Regional Medical Center - Plymouth

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $454
  • Cash Discount Price: $492
  • vs. Medicare Baseline: 2.89x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Saint Joseph Regional Medical Center - Plymouth is $454. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $492. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 2.89x the Medicare baseline. Located in 1915 Lake Ave, Plymouth, IN.
Cash / Self-Pay
$492

Average discount available for prompt cash payment at this facility.

Insurance Median
$454

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: $492 (313%)
Insurance Median: $454 (289%)
Cash: $492 (313% of Medicare)
Ins. Median: $454 (289% 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 289% of the Medicare baseline (a markup of 189%). 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
Aetna $60 - $492 38%
Blue Cross Blue Shield $60 - $327 38%
Medicaid / KanCare $60 - $327 38%
UnitedHealthcare $60 - $327 38%
Medicare (plans) $102 - $104 65%
Meridian Complete $102 65%
Pace-Trinity Health $102 65%
County Coroner $106 68%
Provider Partners Health Plan Of Indiana $112 71%
Auxiant $153 - $628 97%
Physicians Health Plan Northern Indiana Health Insurance $153 - $309 97%
St Joseph County Hlth Dpt $153 97%
Caresource $158 101%
Siho Insurance Services $164 104%
Key Benefit Administrator $184 - $531 117%
Allied Benefit Systems $194 - $492 124%
Blue Benefit Administrators Of Massachusetts $204 130%
Blue Care Network $204 130%
Blue Distinction Transplant $204 130%
Blue Shield - Ca $204 130%
Blue Shield - Id (Regence) $204 130%
Blue Shield - Ny Highmark Northeastern $204 130%
Blue Shield - Ny Highmark Western $204 130%
Blue Shield - Pa (Highmark) $204 130%
Blue Shield - Wa (Regence) $204 130%
Plain Church Group $204 130%
Custom Design Benefits $220 140%
Geha $315 201%
Healthscope $315 201%
Student Insurance Cma $315 201%
Managed Health Services - Indiana $327 208%
Mdwise $327 208%
Notre Dame Athletic Association $416 265%
Wc Notre Dame $416 265%
Luminare Health (Detroit) $431 - $454 275%
Ameriben $454 289%
Asr Health Benefits $492 313%
Christian Brother Services $492 313%
Employee Benefit Management $492 313%
Medical Mutual $492 313%
Meritain $492 313%
Preferred One $492 313%
Rural Carrier Health Benefit Plan $492 313%
Webtpa $492 313%
Encore Health $531 338%
Indiana Criminal Justice Inst $531 338%
Western & Southern Financial Group $531 338%
Cigna $545 347%
Group Administrators $545 347%
Health Partners $545 347%
Mvp $545 347%
Prairie States $545 347%
Priority Health $545 347%
Professional Benefit Administrators $545 347%
Sagamore Health Network $545 - $583 347%
Sisco Benefits $545 347%
Unified Group Services $545 347%
Goshen Preferred Network $583 - $651 371%
Signature Care $628 400%
Allied National Global Care $681 434%
Asrm - Reliance Standard Life Insurance $681 434%
Avmed Health Plan $681 434%
Christian Care Ministry $681 434%
Dean Health $681 434%
Fallon Health $681 434%
Family Life Insurance Company $681 434%
Freedom Life Insurance Company $681 434%
Ghc Scw $681 434%
International Benefit Administrators $681 434%
Lifetime Benefit Solutions $681 434%
Manhattan Life $681 434%
Medi Share $681 434%
Multiplan $681 434%
Pai $681 434%
Pan-American Life $681 434%
Paramount Hmo $681 434%
Phcs $681 434%
Philadelphia American Life Insurance $681 434%
Trinity Health Share $681 434%
Bankers Life Casualty $757 482%
Bureau Of Disability $757 482%
Wc Align Network $757 482%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1915 Lake Ave, Plymouth, IN 46563
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals