CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Franciscan Health Rensselaer, Inc

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $245
Cash Discount Price: $127
vs. Medicare Baseline: 1.94x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Franciscan Health Rensselaer, Inc is $245. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.94x the Medicare baseline. Located in 1104 E Grace St, Rensselaer, IN.

Cash / Self-Pay

$127

Average discount available for prompt cash payment at this facility.

Insurance Median

$245

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: $127 (101%)

Insurance Median: $245 (194%)

Cash: $127 (101% of Medicare)

Ins. Median: $245 (194% 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	$84 - $169	67%
Medicare (plans)	$89	70%
Unicare [1150]	$169	134%
Workers Comp [1172]	$178	141%
Commercial [2001]	$218 - $384	173%
Managed Care [2000]	$218 - $384	173%
United Medical Resources [1158]	$218	173%
United Medical Resources [1301]	$218	173%
UnitedHealthcare	$218	173%
Aetna	$245	194%
Mdwise [1175]	$270	214%
Medicaid / KanCare	$270 - $324	214%
Cigna	$278	220%
Great West Insurance [1055]	$278	220%
Managed Health Services [1302]	$279	221%

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 $127.
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 Franciscan Health Rensselaer, Inc 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.