CMS Price Transparency Data
Screening mammogram (both breasts)
Facility: St Joe Mercy Hospital System Livonia
Billing Code: 77067 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 77067
- Insurance Median: $255
- Cash Discount Price: $320
- vs. Medicare Baseline: 2.02x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at St Joe Mercy Hospital System Livonia is $255. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $320. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.02x the Medicare baseline. Located in 36475 Five Mile Road, Livonia, MI.
Cash / Self-Pay
$320
Average discount available for prompt cash payment at this facility.
Insurance Median
$255
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: $320 (253%)
Insurance Median: $255 (202%)
Cash: $320 (253% of Medicare)
Ins. Median: $255 (202% 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 202% of the Medicare baseline (a markup of 102%). 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.
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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 | $48 - $182 | 38% |
| Medicaid / KanCare | $48 - $49 | 38% |
| Aetna | $86 - $320 | 68% |
| Blue Care Network Advantage | $86 | 68% |
| Hospice Of Michigan | $86 | 68% |
| Medicare (plans) | $86 - $93 | 68% |
| Align Senior Care | $88 | 70% |
| Angela Hospice | $88 | 70% |
| UnitedHealthcare | $91 - $373 | 72% |
| Cca - Zing Health | $93 | 74% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $99 | 78% |
| Wc Accident Fund | $113 - $164 | 90% |
| Wc Advantage | $113 - $164 | 90% |
| Wc Aig | $113 - $164 | 90% |
| Wc Allied | $113 - $164 | 90% |
| Wc Amerisure | $113 - $164 | 90% |
| Wc Amtrust | $113 - $164 | 90% |
| Wc Asu Risk Mgt | $113 - $164 | 90% |
| Wc Berkley Admin | $113 - $164 | 90% |
| Wc Broadspire | $113 - $164 | 90% |
| Wc Bunch & Associates | $113 - $164 | 90% |
| Wc Ccmsi | $113 - $164 | 90% |
| Wc Emc Insurance Company | $113 - $164 | 90% |
| Wc Esis | $113 - $164 | 90% |
| Wc Fcci | $113 - $164 | 90% |
| Wc Federated | $113 - $164 | 90% |
| Wc Gallagher Bassett | $113 - $164 | 90% |
| Wc Genex Care For Ohio | $113 - $164 | 90% |
| Wc Guard Insurance Company | $113 - $164 | 90% |
| Wc Hartford | $113 - $164 | 90% |
| Wc Liberty Mutual | $113 - $164 | 90% |
| Wc Meijers | $113 - $164 | 90% |
| Wc Michigan | $113 - $164 | 90% |
| Wc Mitchell Frankenmuth | $113 - $164 | 90% |
| Wc Pma | $113 - $164 | 90% |
| Wc Sedgwick | $113 - $164 | 90% |
| Wc Sentry | $113 - $164 | 90% |
| Wc Travelers | $113 - $164 | 90% |
| Wc Tristar | $113 - $164 | 90% |
| Wc Walmart | $113 - $164 | 90% |
| Wc Zurich | $113 - $164 | 90% |
| Molina Marketplace | $115 | 91% |
| Vitalcore | $129 | 102% |
| Health Cost Solutions | $137 | 109% |
| Wellpath | $137 | 109% |
| Acs Benefit Services | $172 - $249 | 136% |
| Allied Benefit Systems | $172 - $249 | 136% |
| Claimchoice Adminstrators | $172 - $249 | 136% |
| Consociate | $172 - $249 | 136% |
| Cypress Benefit Administrators | $172 - $249 | 136% |
| Forest County Potawatomi | $172 - $249 | 136% |
| Health Smart | $172 - $249 | 136% |
| Healthgram | $172 - $249 | 136% |
| Healthscope | $172 - $249 | 136% |
| Secureone Preferred United Plans | $172 - $249 | 136% |
| Sisco Benefits | $172 - $249 | 136% |
| The Health Plan | $172 - $249 | 136% |
| Trustmark Small Business Benefits | $172 - $249 | 136% |
| Unified Group Services | $172 - $249 | 136% |
| Webtpa | $172 - $249 | 136% |
| Bcn Domestic | $182 | 144% |
| Blue Benefit Administrators Of Massachusetts | $182 | 144% |
| Blue Care Network | $182 | 144% |
| Blue Distinction Transplant | $182 | 144% |
| Blue Shield - Ca | $182 | 144% |
| Blue Shield - Id (Regence) | $182 | 144% |
| Blue Shield - Ny Highmark Northeastern | $182 | 144% |
| Blue Shield - Ny Highmark Western | $182 | 144% |
| Blue Shield - Pa (Highmark) | $182 | 144% |
| Blue Shield - Wa (Regence) | $182 | 144% |
| Health Choices | $182 - $370 | 144% |
| Kaiser Domestic | $182 | 144% |
| Priority Health | $183 - $203 | 145% |
| Employee Benefit Logistic | $199 | 158% |
| Asr Health Benefits | $219 | 173% |
| Caresource | $219 | 173% |
| Hap | $219 - $357 | 173% |
| Varipro | $219 | 173% |
| Health Partners | $247 - $357 | 196% |
| Tufts Health Plan | $247 - $357 | 196% |
| Cigna | $252 - $466 | 200% |
| Access Health | $255 - $370 | 202% |
| Acclaim | $255 - $370 | 202% |
| Administrative Concepts | $255 - $370 | 202% |
| Allegeant | $255 - $370 | 202% |
| Ameriben | $255 - $370 | 202% |
| American Family | $255 - $370 | 202% |
| American Healthcare Alliance | $255 - $370 | 202% |
| American National | $255 - $370 | 202% |
| American Republic | $255 - $370 | 202% |
| Amerihealth | $255 - $370 | 202% |
| Aultcare | $255 - $370 | 202% |
| Automated Benefit Services | $255 - $370 | 202% |
| Auxiant | $255 - $370 | 202% |
| Benefit Administrative Systems,Llc | $255 - $370 | 202% |
| Boon Chapman | $255 - $370 | 202% |
| Cam Administrative Services | $255 - $370 | 202% |
| Christian Brother Services | $255 - $370 | 202% |
| Christian Brothers Holy Cross | $255 - $370 | 202% |
| Comprehensive Benefits | $255 - $370 | 202% |
| Continental Life Insurance | $255 - $370 | 202% |
| Custom Benefit Administrators | $255 - $370 | 202% |
| Employee Benefit Concepts | $255 - $370 | 202% |
| Employee Benefit Management | $255 - $370 | 202% |
| Enterprise Group Planning | $255 - $370 | 202% |
| Freedom Life Insurance Company | $255 - $370 | 202% |
| Group Administrators | $255 - $370 | 202% |
| Group Marketing Services | $255 - $370 | 202% |
| Guardian | $255 - $370 | 202% |
| Health America | $255 - $370 | 202% |
| Healthcare Management Admin | $255 - $370 | 202% |
| Healthez | $255 - $370 | 202% |
| Humana | $255 - $370 | 202% |
| Insight | $255 - $370 | 202% |
| Intercare | $255 - $370 | 202% |
| Jfp Benefit Management | $255 - $370 | 202% |
| Jp Farley Corporation | $255 - $370 | 202% |
| Key Benefit Administrator | $255 - $370 | 202% |
| Liberty Union Life Assurance Co | $255 - $370 | 202% |
| Lucent Health | $255 - $370 | 202% |
| Luminare Health | $255 - $370 | 202% |
| Magnacare | $255 - $370 | 202% |
| Medben | $255 - $370 | 202% |
| Medcost | $255 - $370 | 202% |
| Medical Mutual | $255 - $370 | 202% |
| Mutual Health Services | $255 - $370 | 202% |
| Mutual Of Omaha | $255 - $370 | 202% |
| Ncas | $255 - $370 | 202% |
| Nippon Life Ins | $255 - $370 | 202% |
| Nova | $255 - $370 | 202% |
| Painters Union Insurance Fund | $255 - $370 | 202% |
| Physicians Mutual | $255 - $370 | 202% |
| Plumbers Local 98 Insurance Fund | $255 - $370 | 202% |
| Prairie States | $255 - $370 | 202% |
| Preferred One | $255 - $370 | 202% |
| Primary Physician Care | $255 - $370 | 202% |
| Professional Benefit Administrators | $255 - $370 | 202% |
| Siho Insurance Services | $255 - $370 | 202% |
| The Loomis Company | $255 - $370 | 202% |
| Unicare | $255 - $370 | 202% |
| Us Health And Life | $255 - $370 | 202% |
| Valenz | $255 - $370 | 202% |
| Western & Southern Financial Group | $255 - $370 | 202% |
| Wps | $255 - $370 | 202% |
| 1199 National Benefit Fund | $257 - $372 | 204% |
| Allied National Global Care | $257 - $372 | 204% |
| Asrm - Reliance Standard Life Insurance | $257 - $372 | 204% |
| Christian Care Ministry | $257 - $372 | 204% |
| Dean Health | $257 - $372 | 204% |
| Fallon Health | $257 - $372 | 204% |
| Family Life Insurance Company | $257 - $372 | 204% |
| Ghc Scw | $257 - $372 | 204% |
| Group Pension Administrators | $257 - $372 | 204% |
| International Benefit Administrators | $257 - $372 | 204% |
| Lifetime Benefit Solutions | $257 - $372 | 204% |
| Manhattan Life | $257 - $372 | 204% |
| Medi Share | $257 - $372 | 204% |
| Multiplan | $257 - $372 | 204% |
| Mvp | $257 - $372 | 204% |
| Pai | $257 - $372 | 204% |
| Pan-American Life | $257 - $372 | 204% |
| Paramount Hmo | $257 - $372 | 204% |
| Phcs | $257 - $372 | 204% |
| Trinity Health Share | $257 - $372 | 204% |
| Geha | $258 - $373 | 204% |
| First Health | $263 - $380 | 208% |
| U Of M Health Plan | $280 | 222% |
| Luminare Health (Detroit) | $320 | 253% |
| Meritain | $320 | 253% |
| Coventry | $322 - $466 | 255% |
| Prime Health Services | $322 - $466 | 255% |
| Three Rivers Provider Network | $362 - $524 | 287% |
| Carelon Behavioral Health | $402 - $582 | 318% |
| Cmh Detroit Wayne Integrated Health Network | $402 - $582 | 318% |
| Cmh Lenawee County | $402 - $582 | 318% |
| Cmh Livingston County | $402 - $582 | 318% |
| Cmh Misc | $402 - $582 | 318% |
| Cmh Monroe County | $402 - $582 | 318% |
| Cmh Washtenaw County | $402 - $582 | 318% |
| Magellan Behavioral Health | $402 - $582 | 318% |