CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Rush Memorial Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $193
Cash Discount Price: $85
vs. Medicare Baseline: 1.53x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Rush Memorial Hospital is $193. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $85. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.53x the Medicare baseline. Located in 1300 N Main St, Rushville, IN.

Cash / Self-Pay

$85

Average discount available for prompt cash payment at this facility.

Insurance Median

$193

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: $85 (67%)

Insurance Median: $193 (153%)

Cash: $85 (67% of Medicare)

Ins. Median: $193 (153% 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
Coventry/First Health-All Plans	$16 - $2,735	13%
UnitedHealthcare	$29 - $2,431	23%
Aetna	$34 - $2,795	27%
Caresource Mcr Adv	$34 - $942	27%
Consumers Life Ins-All Plans	$34 - $2,735	27%
Humana	$34 - $2,795	27%
Blue Cross Blue Shield	$35 - $2,345	28%
My True Advantage - All Plans	$35 - $942	28%
Today'S Option Mcr Adv-All Plans	$35 - $970	28%
Viant Beech St Mcr Adv	$35 - $970	28%
Caresource Marketplace-All Other Plans	$46 - $1,507	36%
Multiplan-All Plans	$47 - $2,826	37%
Cigna	$55 - $1,388	44%
Health Net	$55 - $895	44%
Encore Health Services-All Plans	$59 - $2,978	47%
Siho-All Plans	$59 - $2,795	47%
Phcs-All Plans	$63 - $2,431	50%
Sagamore-All Plans	$338 - $2,795	268%
Community Health Alliance-All Plans	$346 - $2,856	274%

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 $85.
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 Rush Memorial 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.