CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Monroe Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $178
Cash Discount Price: $102
vs. Medicare Baseline: 1.13x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Monroe Hospital is $178. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.13x the Medicare baseline. Located in 4011 S Monroe Medical Park Blvd, Bloomington, IN.

Cash / Self-Pay

$102

Average discount available for prompt cash payment at this facility.

Insurance Median

$178

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: $102 (65%)

Insurance Median: $178 (113%)

Cash: $102 (65% of Medicare)

Ins. Median: $178 (113% 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.

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
Aetna	$102	65%
Blue Cross Blue Shield	$102 - $327	65%
Care Source	$102 - $327	65%
Medicare (plans)	$102	65%
Tricare	$102	65%
UnitedHealthcare	$102 - $327	65%
Usa Senior Care Network	$102	65%
Worthington Christian Fellowship	$102	65%
Monroe Medical Group And Managed Health Services	$104 - $327	66%
Provider Partners Health Plan	$112	71%
Employer Direct Healthcare	$143	91%
Pathfinder Advisor	$158	101%
Corvel Workers Compensation	$178	113%
Zelis Healthcare Fka Stratose	$194	124%
Americas Choice Provider Network Acpn	$198	126%
Multiplan	$198	126%
Prime Health Services	$198	126%
Three Rivers	$198	126%
Encore Health Network Workers Compensation	$200	127%
Provider Select	$202	129%
Provider Network Of America	$204	130%
Workers Compensation	$204	130%
Medicaid / KanCare	$327	208%

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 $102.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77066.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Monroe Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77066.
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.