CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Woodlawn Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $98
Cash Discount Price: $292
vs. Medicare Baseline: 0.78x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Woodlawn Hospital is $98. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $292. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.78x the Medicare baseline. Located in 1400 E 9Th St, Rochester, IN.

Cash / Self-Pay

$292

Average discount available for prompt cash payment at this facility.

Insurance Median

$98

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: $292 (231%)

Insurance Median: $98 (78%)

Cash: $292 (231% of Medicare)

Ins. Median: $98 (78% 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
Blue Cross Blue Shield	$69 - $338	55%
Caresource Mcaid Hww	$69	55%
Mdwise Excel Hhw & Hcc	$69	55%
Mhs Mcaid Hcc	$69	55%
Mhs Mcaid Hhw	$69	55%
UnitedHealthcare	$69 - $338	55%
Aetna	$73 - $423	58%
Caresource Mcaid Hip	$73 - $98	58%
Caresource Mcr Adv	$73 - $98	58%
Humana	$73 - $345	58%
Mdwise Mcaid Excel Hip	$73 - $98	58%
Mhs Exch Mrktplce-All Other Plans	$73 - $98	58%
Mhs Mcaid Hip	$73 - $98	58%
Mhs Mcr Adv	$75 - $100	59%
Caresource Exch - All Other Plans	$96 - $127	76%
Ambetter / Centene	$98 - $130	78%
Partners Direct Health-All Plans	$227 - $303	180%
Cigna	$239 - $378	189%
Parkview Health Plans-All Plans	$250 - $334	198%
Sagamore All Other Grps - All Other Plans	$281 - $374	223%
Encore Comm-All Plans	$284 - $378	225%
Phcs/Multiplan-All Plans	$311 - $414	246%
Community Health Alliance-All Plans	$317 - $423	251%

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 $292.
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 Woodlawn 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.