CMS Price Transparency Data
Diagnostic mammogram (both breasts)
Facility: St Joe Mercy Hospital System Livonia
Billing Code: 77066 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 77066
- Insurance Median: $532
- Cash Discount Price: $548
- vs. Medicare Baseline: 3.39x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at St Joe Mercy Hospital System Livonia is $532. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $548. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 3.39x the Medicare baseline. Located in 36475 Five Mile Road, Livonia, MI.
Cash / Self-Pay
$548
Average discount available for prompt cash payment at this facility.
Insurance Median
$532
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: $548 (349%)
Insurance Median: $532 (339%)
Cash: $548 (349% of Medicare)
Ins. Median: $532 (339% 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 339% of the Medicare baseline (a markup of 239%). 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 |
|---|---|---|
| Blue Cross Blue Shield | $59 - $220 | 38% |
| Medicaid / KanCare | $59 - $60 | 38% |
| Aetna | $105 - $386 | 67% |
| Blue Care Network Advantage | $105 | 67% |
| Hospice Of Michigan | $105 | 67% |
| Medicare (plans) | $105 - $113 | 67% |
| Align Senior Care | $107 | 68% |
| Angela Hospice | $107 | 68% |
| UnitedHealthcare | $110 - $540 | 70% |
| Cca - Zing Health | $113 | 72% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $121 | 77% |
| Molina Marketplace | $139 | 89% |
| Vitalcore | $157 | 100% |
| Health Cost Solutions | $166 | 106% |
| Wellpath | $166 | 106% |
| Bcn Domestic | $220 | 140% |
| Blue Benefit Administrators Of Massachusetts | $220 | 140% |
| Blue Care Network | $220 | 140% |
| Blue Distinction Transplant | $220 | 140% |
| Blue Shield - Ca | $220 | 140% |
| Blue Shield - Id (Regence) | $220 | 140% |
| Blue Shield - Ny Highmark Northeastern | $220 | 140% |
| Blue Shield - Ny Highmark Western | $220 | 140% |
| Blue Shield - Pa (Highmark) | $220 | 140% |
| Blue Shield - Wa (Regence) | $220 | 140% |
| Health Choices | $220 - $535 | 140% |
| Kaiser Domestic | $220 | 140% |
| Priority Health | $221 - $246 | 141% |
| Wc Accident Fund | $238 | 152% |
| Wc Advantage | $238 | 152% |
| Wc Aig | $238 | 152% |
| Wc Allied | $238 | 152% |
| Wc Amerisure | $238 | 152% |
| Wc Amtrust | $238 | 152% |
| Wc Asu Risk Mgt | $238 | 152% |
| Wc Berkley Admin | $238 | 152% |
| Wc Broadspire | $238 | 152% |
| Wc Bunch & Associates | $238 | 152% |
| Wc Ccmsi | $238 | 152% |
| Wc Emc Insurance Company | $238 | 152% |
| Wc Esis | $238 | 152% |
| Wc Fcci | $238 | 152% |
| Wc Federated | $238 | 152% |
| Wc Gallagher Bassett | $238 | 152% |
| Wc Genex Care For Ohio | $238 | 152% |
| Wc Guard Insurance Company | $238 | 152% |
| Wc Hartford | $238 | 152% |
| Wc Liberty Mutual | $238 | 152% |
| Wc Meijers | $238 | 152% |
| Wc Michigan | $238 | 152% |
| Wc Mitchell Frankenmuth | $238 | 152% |
| Wc Pma | $238 | 152% |
| Wc Sedgwick | $238 | 152% |
| Wc Sentry | $238 | 152% |
| Wc Travelers | $238 | 152% |
| Wc Tristar | $238 | 152% |
| Wc Walmart | $238 | 152% |
| Wc Zurich | $238 | 152% |
| Employee Benefit Logistic | $241 | 154% |
| Asr Health Benefits | $265 | 169% |
| Caresource | $265 | 169% |
| Hap | $265 - $517 | 169% |
| Varipro | $265 | 169% |
| U Of M Health Plan | $346 | 220% |
| Acs Benefit Services | $360 | 229% |
| Allied Benefit Systems | $360 | 229% |
| Claimchoice Adminstrators | $360 | 229% |
| Consociate | $360 | 229% |
| Cypress Benefit Administrators | $360 | 229% |
| Forest County Potawatomi | $360 | 229% |
| Health Smart | $360 | 229% |
| Healthgram | $360 | 229% |
| Healthscope | $360 | 229% |
| Secureone Preferred United Plans | $360 | 229% |
| Sisco Benefits | $360 | 229% |
| The Health Plan | $360 | 229% |
| Trustmark Small Business Benefits | $360 | 229% |
| Unified Group Services | $360 | 229% |
| Webtpa | $360 | 229% |
| Geha | $386 - $540 | 246% |
| Luminare Health (Detroit) | $386 | 246% |
| Meritain | $386 | 246% |
| Health Partners | $517 | 329% |
| Tufts Health Plan | $517 | 329% |
| Cigna | $528 - $674 | 336% |
| Access Health | $535 | 341% |
| Acclaim | $535 | 341% |
| Administrative Concepts | $535 | 341% |
| Allegeant | $535 | 341% |
| Ameriben | $535 | 341% |
| American Family | $535 | 341% |
| American Healthcare Alliance | $535 | 341% |
| American National | $535 | 341% |
| American Republic | $535 | 341% |
| Amerihealth | $535 | 341% |
| Aultcare | $535 | 341% |
| Automated Benefit Services | $535 | 341% |
| Auxiant | $535 | 341% |
| Benefit Administrative Systems,Llc | $535 | 341% |
| Boon Chapman | $535 | 341% |
| Cam Administrative Services | $535 | 341% |
| Christian Brother Services | $535 | 341% |
| Christian Brothers Holy Cross | $535 | 341% |
| Comprehensive Benefits | $535 | 341% |
| Continental Life Insurance | $535 | 341% |
| Custom Benefit Administrators | $535 | 341% |
| Employee Benefit Concepts | $535 | 341% |
| Employee Benefit Management | $535 | 341% |
| Enterprise Group Planning | $535 | 341% |
| Freedom Life Insurance Company | $535 | 341% |
| Group Administrators | $535 | 341% |
| Group Marketing Services | $535 | 341% |
| Guardian | $535 | 341% |
| Health America | $535 | 341% |
| Healthcare Management Admin | $535 | 341% |
| Healthez | $535 | 341% |
| Humana | $535 | 341% |
| Insight | $535 | 341% |
| Intercare | $535 | 341% |
| Jfp Benefit Management | $535 | 341% |
| Jp Farley Corporation | $535 | 341% |
| Key Benefit Administrator | $535 | 341% |
| Liberty Union Life Assurance Co | $535 | 341% |
| Lucent Health | $535 | 341% |
| Luminare Health | $535 | 341% |
| Magnacare | $535 | 341% |
| Medben | $535 | 341% |
| Medcost | $535 | 341% |
| Medical Mutual | $535 | 341% |
| Mutual Health Services | $535 | 341% |
| Mutual Of Omaha | $535 | 341% |
| Ncas | $535 | 341% |
| Nippon Life Ins | $535 | 341% |
| Nova | $535 | 341% |
| Painters Union Insurance Fund | $535 | 341% |
| Physicians Mutual | $535 | 341% |
| Plumbers Local 98 Insurance Fund | $535 | 341% |
| Prairie States | $535 | 341% |
| Preferred One | $535 | 341% |
| Primary Physician Care | $535 | 341% |
| Professional Benefit Administrators | $535 | 341% |
| Siho Insurance Services | $535 | 341% |
| The Loomis Company | $535 | 341% |
| Unicare | $535 | 341% |
| Us Health And Life | $535 | 341% |
| Valenz | $535 | 341% |
| Western & Southern Financial Group | $535 | 341% |
| Wps | $535 | 341% |
| 1199 National Benefit Fund | $540 | 344% |
| Allied National Global Care | $540 | 344% |
| Asrm - Reliance Standard Life Insurance | $540 | 344% |
| Christian Care Ministry | $540 | 344% |
| Dean Health | $540 | 344% |
| Fallon Health | $540 | 344% |
| Family Life Insurance Company | $540 | 344% |
| Ghc Scw | $540 | 344% |
| Group Pension Administrators | $540 | 344% |
| International Benefit Administrators | $540 | 344% |
| Lifetime Benefit Solutions | $540 | 344% |
| Manhattan Life | $540 | 344% |
| Medi Share | $540 | 344% |
| Multiplan | $540 | 344% |
| Mvp | $540 | 344% |
| Pai | $540 | 344% |
| Pan-American Life | $540 | 344% |
| Paramount Hmo | $540 | 344% |
| Phcs | $540 | 344% |
| Trinity Health Share | $540 | 344% |
| First Health | $551 | 351% |
| Coventry | $674 | 429% |
| Prime Health Services | $674 | 429% |
| Three Rivers Provider Network | $759 | 484% |
| Carelon Behavioral Health | $843 | 537% |
| Cmh Detroit Wayne Integrated Health Network | $843 | 537% |
| Cmh Lenawee County | $843 | 537% |
| Cmh Livingston County | $843 | 537% |
| Cmh Misc | $843 | 537% |
| Cmh Monroe County | $843 | 537% |
| Cmh Washtenaw County | $843 | 537% |
| Magellan Behavioral Health | $843 | 537% |