CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Perry County Memorial Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $270
  • Cash Discount Price: $413
  • vs. Medicare Baseline: 2.14x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Perry County Memorial Hospital is $270. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $413. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.14x the Medicare baseline. Located in 8885 Sr 237, Tell City, IN.
Cash / Self-Pay
$413

Average discount available for prompt cash payment at this facility.

Insurance Median
$270

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: $413 (327%)
Insurance Median: $270 (214%)
Cash: $413 (327% of Medicare)
Ins. Median: $270 (214% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 214% of the Medicare baseline (a markup of 114%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Bc 130 $83 - $649 66%
Group Insurance $83 - $812 66%
Medicaid / KanCare $83 - $812 66%
Medicare (plans) $83 - $211 66%
Veterans Administration $83 - $812 66%
Workers Compensation $184 - $406 146%
Nsa $216 - $501 171%
Guarantor Liable $258 - $812 204%
Pcmh Insurnace $287 - $812 227%
Secondary Insurance $294 - $649 233%
UnitedHealthcare $294 - $649 233%
Operating Engineers $313 - $690 248%
Boilermakers Healthcare $320 - $706 253%
Cigna $320 - $706 253%
Great West $320 - $812 253%
Sagxxxx $320 - $706 253%
Champus $368 - $812 291%
Ngs American, Inc $368 - $812 291%
Patoka Valley $368 - $812 291%
Southwire $368 - $812 291%
Tricare $368 - $812 291%
Wausau Benefits $368 - $812 291%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 8885 Sr 237, Tell City, IN 47586
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals