CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Fairview Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $244
  • Cash Discount Price: $364
  • vs. Medicare Baseline: 1.93x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Fairview Hospital is $244. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $364. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.93x the Medicare baseline. Located in 29 Lewis Avenue, Great Barrington, MA.
Cash / Self-Pay
$364

Average discount available for prompt cash payment at this facility.

Insurance Median
$244

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: $364 (288%)
Insurance Median: $244 (193%)
Cash: $364 (288% of Medicare)
Ins. Median: $244 (193% 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.

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
Capital District Physicians' Health Plan $84 - $345 67%
Medicaid / KanCare $84 - $171 67%
Blue Cross Blue Shield $94 - $325 74%
Commcare Alliance $94 - $155 74%
Fallon $94 - $168 74%
Medicare (plans) $94 - $129 74%
Hospice $96 - $132 76%
Other Government $96 - $144 76%
UnitedHealthcare $96 - $329 76%
Health New England $97 - $267 77%
Aetna $110 - $289 87%
Point32Health $164 - $364 130%
Bmchnp $171 - $178 135%
Comm Fallon Qhp $196 - $236 155%
Comm Hne Hmo $244 - $252 193%
Workers Comp $244 193%
Allways Nhp $248 196%
Unicare $248 - $297 196%
Comm Hne Ppo $260 - $268 206%
Cigna $345 - $356 273%
Mvp $345 273%
Oxford $345 273%
First Health $356 - $364 282%
Connecticare $364 288%
Consolidated Health Plans $364 288%
Other Commercial $364 288%
Phcs $364 288%
Self Pay $364 288%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 29 Lewis Avenue, Great Barrington, MA 01230
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals