CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Norton Scott Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $291
Cash Discount Price: $101
vs. Medicare Baseline: 2.30x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Norton Scott Hospital is $291. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $101. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.30x the Medicare baseline. Located in 1451 N Gardner St, Scottsburg, IN.

Cash / Self-Pay

$101

Average discount available for prompt cash payment at this facility.

Insurance Median

$291

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: $101 (80%)

Insurance Median: $291 (230%)

Cash: $101 (80% of Medicare)

Ins. Median: $291 (230% 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 230% of the Medicare baseline (a markup of 130%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Caresource Indiana Healthy Indiana Plan (Hip)	$69	55%
Managed Health Services (Mhs)	$69 - $131	55%
Managed Health Services (Mhs) Hoosier Care Connect	$69	55%
UnitedHealthcare	$69 - $326	55%
Caresource Indiana Hoosier Healthwise (Hhw)	$70	55%
Mdwise Hoosier Healthwise (Hhw)	$73	58%
Molina Healthcare	$85 - $87	67%
Blue Cross Blue Shield	$102 - $321	81%
Managed Health Services (Mhs) Healthy Indiana Plan (Hip)	$111 - $131	88%
Mdwise Healthy Indiana Plan (Hip)	$111 - $131	88%
Communicare Advantage	$114 - $135	90%
Caresource Indiana Just4Me	$166 - $197	131%
Aetna	$291 - $345	230%
Multiplan	$370 - $465	293%
Cigna	$393 - $465	311%
Encore Health Network	$393 - $465	311%
Prime Health	$393 - $465	311%
Ppom	$407 - $481	322%
Intercommunity Health Network (Ihn)	$416 - $492	330%

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 $101.
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 Norton Scott 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.