CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Pulaski Memorial Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $116
Cash Discount Price: $190
vs. Medicare Baseline: 0.92x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Pulaski Memorial Hospital is $116. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $190. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.92x the Medicare baseline. Located in 616 E 13Th St, Winamac, IN.

Cash / Self-Pay

$190

Average discount available for prompt cash payment at this facility.

Insurance Median

$116

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: $190 (150%)

Insurance Median: $116 (92%)

Cash: $190 (150% of Medicare)

Ins. Median: $116 (92% 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	$31 - $441	25%
Ambetter / Centene	$34 - $173	27%
Blue Cross Blue Shield	$34 - $359	27%
Caresource Mcaid Hip	$34 - $173	27%
Caresource Mcare Hmo	$34 - $173	27%
Cenpatico Mcaid Hip	$34 - $173	27%
Humana	$34 - $449	27%
Mdwise Mcaid Hcc	$34 - $69	27%
Mdwise Mcaid Hhw	$34 - $69	27%
Mdwise Mcaid Hip - All Other Plans	$34 - $173	27%
Mhs Mcaid Hip	$34 - $173	27%
Mhs Mcare Allwell	$34 - $175	27%
Multiplan - All Plans	$34 - $502	27%
Caresource Exch Hmo Hix - All Other Plans	$42 - $216	33%
Encore Ppo - All Other Plans	$51 - $474	40%
Community Health Alliance - All Plans	$67 - $497	53%
Caresource Mcaid Hhw	$69 - $116	55%
Cenpatico Mcaid Hhw - All Other Plans	$69 - $116	55%
Mhs Mcaid Hhw/Hcc	$69 - $116	55%
Encore Workers Comp	$95 - $502	75%
Aetna	$97 - $201	77%
Sagamore Rose Acre	$202 - $416	160%
Sagamore - All Other Plans	$205 - $422	162%
Cigna	$257 - $530	204%

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 $190.
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 Pulaski 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.