CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: The Women's Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $185
Cash Discount Price: $439
vs. Medicare Baseline: 1.47x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at The Women's Hospital is $185. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $439. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.47x the Medicare baseline. Located in 4199 Gateway Blvd, Newburgh, IN.

Cash / Self-Pay

$439

Average discount available for prompt cash payment at this facility.

Insurance Median

$185

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: $439 (348%)

Insurance Median: $185 (147%)

Cash: $439 (348% of Medicare)

Ins. Median: $185 (147% 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
UnitedHealthcare	$29 - $596	23%
Chamber Care	$34 - $521	27%
Immergrun	$40 - $311	32%
Amish	$50	40%
Self Pay	$50 - $439	40%
Encorecombined	$53 - $521	42%
Encoreprime	$53 - $506	42%
Blue Cross Blue Shield	$69 - $263	55%
Caresource Hip	$69	55%
Caresource In	$69	55%
Mdwise Hip	$69	55%
Mhs Behavioral	$69	55%
Alliance Coal	$86 - $516	68%
Allied National/Zelis - Freedom Plan	$86	68%
Center Care	$86 - $581	68%
Cigna	$86 - $536	68%
Patoka Valley Health Care (80/20 Plan)	$86 - $462	68%
Patoka Valley Health Care (90/10 Plan)	$86 - $447	68%
Sagamore	$86 - $536	68%
Claimdoc	$98	78%
Aetna	$101 - $496	80%
Claritev (Formerly Phcs/Mulitplan)	$101 - $514	80%
First Health/Coventry	$101 - $551	80%
Healthlink	$101 - $633	80%
Humana	$171	135%
Passport Molina Ky	$171	135%
Wellcare Ky	$171	135%
Iu Health	$372	295%
Ambetter / Centene	$446	353%
One Care	$521	413%

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 $439.
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 The Women's 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.