CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Ascension Providence Hospital, Southfield and Novi

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $103
Cash Discount Price: $268
vs. Medicare Baseline: 0.66x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Ascension Providence Hospital, Southfield and Novi is $103. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $268. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 0.66x the Medicare baseline. Located in 16001 W Nine Mile Rd, Southfield, MI.

Cash / Self-Pay

$268

Average discount available for prompt cash payment at this facility.

Insurance Median

$103

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: $268 (171%)

Insurance Median: $103 (66%)

Cash: $268 (171% of Medicare)

Ins. Median: $103 (66% 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.

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
Blue Caid Michigan	$57	36%
Harbor Health Mcd	$57	36%
Medicaid / KanCare	$57 - $99	36%
Molina Health	$57	36%
Total Health Care	$57	36%
UnitedHealthcare	$57	36%
Amerihealth Vip Care Mcr	$85 - $98	54%
Aetna	$99 - $320	63%
Auto Insurance	$99	63%
Jvhl - Mcr Replacement	$99	63%
Mcr Replacement	$99	63%
Veterans Choice	$99	63%
Humana	$100	64%
Hap Alliance Health	$103	66%
Hap Hmo Pos	$103	66%
Meridian Wellcare	$104	66%
Molina Advantage	$104	66%
Bcccp	$117	75%
Priority Ppo	$121	77%
Hap Preferred	$122	78%
Ambetter / Centene	$124	79%
Molina Marketplace	$124	79%
Smart Health	$136	87%
Priority Health Hmo	$141	90%
Bc Metro Detroit Epo	$180 - $227	115%
Bc Metro Detroit Hmo	$202 - $227	129%
Bcn Local Network Southeast	$202 - $227	129%
Blue Care Network	$224 - $227	143%
Blue Cross Blue Shield	$224 - $227	143%

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 $268.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77066.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ascension Providence Hospital, Southfield and Novi is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77066.
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.