CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Monroe Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $147
Cash Discount Price: $84
vs. Medicare Baseline: 1.16x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Monroe Hospital is $147. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $84. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.16x the Medicare baseline. Located in 4011 S Monroe Medical Park Blvd, Bloomington, IN.

Cash / Self-Pay

$84

Average discount available for prompt cash payment at this facility.

Insurance Median

$147

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: $84 (67%)

Insurance Median: $147 (116%)

Cash: $84 (67% of Medicare)

Ins. Median: $147 (116% 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
Aetna	$84	67%
Blue Cross Blue Shield	$84 - $270	67%
Care Source	$84 - $270	67%
Medicare (plans)	$84	67%
Tricare	$84	67%
UnitedHealthcare	$84 - $270	67%
Usa Senior Care Network	$84	67%
Worthington Christian Fellowship	$84	67%
Monroe Medical Group And Managed Health Services	$86 - $270	68%
Provider Partners Health Plan	$93	74%
Employer Direct Healthcare	$118	93%
Pathfinder Advisor	$130	103%
Corvel Workers Compensation	$147	116%
Zelis Healthcare Fka Stratose	$160	127%
Americas Choice Provider Network Acpn	$164	130%
Multiplan	$164	130%
Prime Health Services	$164	130%
Three Rivers	$164	130%
Encore Health Network Workers Compensation	$165	131%
Provider Select	$167	132%
Provider Network Of America	$169	134%
Workers Compensation	$169	134%
Medicaid / KanCare	$270	214%

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 $84.
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 Monroe 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.