CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: St Claire Regional Medical Center

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $385
  • Cash Discount Price: $445
  • vs. Medicare Baseline: 2.45x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at St Claire Regional Medical Center is $385. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $445. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 2.45x the Medicare baseline. Located in 222 Medical Circle, Morehead, KY.
Cash / Self-Pay
$445

Average discount available for prompt cash payment at this facility.

Insurance Median
$385

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$156.98

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $156.98 (100%)
Cash / Self-Pay: $445 (283%)
Insurance Median: $385 (245%)
Cash: $445 (283% of Medicare)
Ins. Median: $385 (245% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $156.98 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 245% of the Medicare baseline (a markup of 145%). 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.

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
Aetna $128 82%
Beacon Bh - All Plans $134 85%
Wellcare Mcaid $136 87%
Blue Cross Blue Shield $143 - $427 91%
Caresource Mcr Adv $143 91%
Humana $143 - $415 91%
Medicaid / KanCare $143 - $167 91%
Caresource Just4Me - All Other Plans $186 118%
Healthlink - All Plans $411 262%
Wellcare Comm - All Other Plans $504 321%
Ky Health Co-Op - All Plans $771 491%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 222 Medical Circle, Morehead, KY 40351
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Federal
  • Hospital Type: Acute Care Hospitals