CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Ascension St Vincent Williamsport

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $100
  • Cash Discount Price: $308
  • vs. Medicare Baseline: 0.79x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Ascension St Vincent Williamsport is $100. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $308. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.79x the Medicare baseline. Located in 412 N Monroe St, Williamsport, IN.
Cash / Self-Pay
$308

Average discount available for prompt cash payment at this facility.

Insurance Median
$100

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: $308 (244%)
Insurance Median: $100 (79%)
Cash: $308 (244% of Medicare)
Ins. Median: $100 (79% 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.

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 $22 - $170 17%
Blue Cross Blue Shield $40 - $270 32%
Aetna $85 67%
Ambetter / Centene $91 72%
Caresource Marketplace $91 72%
Corizon $91 72%
Helping Hand Old Order $91 72%
Humana $91 72%
Immergrun $91 72%
Medicare (plans) $91 72%
Personalized Care $91 72%
Secure Horizons-Pacificare $91 72%
Secure Horizons-Unicare $91 72%
Smarthealth Ppo $91 72%
Encore Exclusive $100 79%
Patoka Valley Tier 1 $100 79%
Patoka Valley Tier 2 $100 79%
Medicaid / KanCare $270 214%
Mhs Care Connect $270 214%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 412 N Monroe St, Williamsport, IN 47993
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals