CMS Price Transparency Data
Screening mammogram (both breasts)
Facility: Trinity Health Oakland Hospital
Billing Code: 77067 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 77067
- Insurance Median: $295
- Cash Discount Price: $320
- vs. Medicare Baseline: 2.34x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Trinity Health Oakland Hospital is $295. 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 2.34x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$320
Average discount available for prompt cash payment at this facility.
Insurance Median
$295
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: $295 (234%)
Cash: $320 (253% of Medicare)
Ins. Median: $295 (234% 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 234% of the Medicare baseline (a markup of 134%). 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 | $48 - $206 | 38% |
| Medicaid / KanCare | $48 - $49 | 38% |
| Aetna | $86 - $320 | 68% |
| Blue Care Network Advantage | $86 | 68% |
| Medicare (plans) | $86 - $88 | 68% |
| Align Senior Care | $88 | 70% |
| Hospice Advantage | $88 | 70% |
| UnitedHealthcare | $91 - $436 | 72% |
| Cca - Zing Health | $93 | 74% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $99 | 78% |
| Molina Marketplace | $115 | 91% |
| Wc Accident Fund | $122 - $177 | 97% |
| Wc Advantage | $122 - $177 | 97% |
| Wc Aig | $122 - $177 | 97% |
| Wc Allied | $122 - $177 | 97% |
| Wc Amerisure | $122 - $177 | 97% |
| Wc Amtrust | $122 - $177 | 97% |
| Wc Asu Risk Mgt | $122 - $177 | 97% |
| Wc Berkley Admin | $122 - $177 | 97% |
| Wc Broadspire | $122 - $177 | 97% |
| Wc Bunch & Associates | $122 - $177 | 97% |
| Wc Ccmsi | $122 - $177 | 97% |
| Wc Emc Insurance Company | $122 - $177 | 97% |
| Wc Esis | $122 - $177 | 97% |
| Wc Fcci | $122 - $177 | 97% |
| Wc Federated | $122 - $177 | 97% |
| Wc Gallagher Bassett | $122 - $177 | 97% |
| Wc Genex Care For Ohio | $122 - $177 | 97% |
| Wc Guard Insurance Company | $122 - $177 | 97% |
| Wc Hartford | $122 - $177 | 97% |
| Wc Liberty Mutual | $122 - $177 | 97% |
| Wc Meijers | $122 - $177 | 97% |
| Wc Michigan | $122 - $177 | 97% |
| Wc Mitchell Frankenmuth | $122 - $177 | 97% |
| Wc Pma | $122 - $177 | 97% |
| Wc Sedgwick | $122 - $177 | 97% |
| Wc Sentry | $122 - $177 | 97% |
| Wc Travelers | $122 - $177 | 97% |
| Wc Tristar | $122 - $177 | 97% |
| Wc Walmart | $122 - $177 | 97% |
| Wc Zurich | $122 - $177 | 97% |
| Vitalcore | $129 | 102% |
| Health Cost Solutions | $137 | 109% |
| Wellpath | $137 | 109% |
| Priority Health | $156 - $173 | 124% |
| Acs Benefit Services | $177 - $256 | 140% |
| Allied Benefit Systems | $177 - $256 | 140% |
| Claimchoice Adminstrators | $177 - $256 | 140% |
| Consociate | $177 - $256 | 140% |
| Cypress Benefit Administrators | $177 - $256 | 140% |
| Forest County Potawatomi | $177 - $256 | 140% |
| Health Smart | $177 - $256 | 140% |
| Healthgram | $177 - $256 | 140% |
| Healthscope | $177 - $256 | 140% |
| Secureone Preferred United Plans | $177 - $256 | 140% |
| Sisco Benefits | $177 - $256 | 140% |
| The Health Plan | $177 - $256 | 140% |
| Trustmark Small Business Benefits | $177 - $256 | 140% |
| Unified Group Services | $177 - $256 | 140% |
| Webtpa | $177 - $256 | 140% |
| Asr Health Benefits | $185 | 147% |
| Caresource | $185 | 147% |
| Hap | $185 - $424 | 147% |
| Varipro | $185 | 147% |
| Mclaren Health | $193 - $305 | 153% |
| Employee Benefit Logistic | $199 | 158% |
| Carelon Behavioral Health | $201 - $291 | 159% |
| Bcn Domestic | $206 | 163% |
| Blue Benefit Administrators Of Massachusetts | $206 | 163% |
| Blue Care Network | $206 | 163% |
| Blue Distinction Transplant | $206 | 163% |
| Blue Shield - Ca | $206 | 163% |
| Blue Shield - Id (Regence) | $206 | 163% |
| Blue Shield - Ny Highmark Northeastern | $206 | 163% |
| Blue Shield - Ny Highmark Western | $206 | 163% |
| Blue Shield - Pa (Highmark) | $206 | 163% |
| Blue Shield - Wa (Regence) | $206 | 163% |
| Health Choices | $206 - $427 | 163% |
| Kaiser Domestic | $206 | 163% |
| Magellan Behavioral Health | $241 - $349 | 191% |
| 1199 National Benefit Fund | $273 - $396 | 216% |
| Allied National Global Care | $273 - $396 | 216% |
| Asrm - Reliance Standard Life Insurance | $273 - $396 | 216% |
| Christian Care Ministry | $273 - $396 | 216% |
| Dean Health | $273 - $396 | 216% |
| Fallon Health | $273 - $396 | 216% |
| Family Life Insurance Company | $273 - $396 | 216% |
| Ghc Scw | $273 - $396 | 216% |
| Group Pension Administrators | $273 - $396 | 216% |
| International Benefit Administrators | $273 - $396 | 216% |
| Lifetime Benefit Solutions | $273 - $396 | 216% |
| Manhattan Life | $273 - $396 | 216% |
| Medi Share | $273 - $396 | 216% |
| Multiplan | $273 - $396 | 216% |
| Mvp | $273 - $396 | 216% |
| Pai | $273 - $396 | 216% |
| Pan-American Life | $273 - $396 | 216% |
| Paramount Hmo | $273 - $396 | 216% |
| Phcs | $273 - $396 | 216% |
| Trinity Health Share | $273 - $396 | 216% |
| U Of M Health Plan | $280 | 222% |
| Health Partners | $293 - $424 | 232% |
| Tufts Health Plan | $293 - $424 | 232% |
| Access Health | $295 - $427 | 234% |
| Acclaim | $295 - $427 | 234% |
| Administrative Concepts | $295 - $427 | 234% |
| Allegeant | $295 - $427 | 234% |
| Ameriben | $295 - $427 | 234% |
| American Family | $295 - $427 | 234% |
| American Healthcare Alliance | $295 - $427 | 234% |
| American National | $295 - $427 | 234% |
| American Republic | $295 - $427 | 234% |
| Amerihealth | $295 - $427 | 234% |
| Aultcare | $295 - $427 | 234% |
| Automated Benefit Services | $295 - $427 | 234% |
| Auxiant | $295 - $427 | 234% |
| Benefit Administrative Systems,Llc | $295 - $427 | 234% |
| Boon Chapman | $295 - $427 | 234% |
| Cam Administrative Services | $295 - $427 | 234% |
| Christian Brother Services | $295 - $427 | 234% |
| Christian Brothers Holy Cross | $295 - $427 | 234% |
| Comprehensive Benefits | $295 - $427 | 234% |
| Continental Life Insurance | $295 - $427 | 234% |
| Custom Benefit Administrators | $295 - $427 | 234% |
| Employee Benefit Concepts | $295 - $427 | 234% |
| Employee Benefit Management | $295 - $427 | 234% |
| Enterprise Group Planning | $295 - $427 | 234% |
| Freedom Life Insurance Company | $295 - $427 | 234% |
| Group Administrators | $295 - $427 | 234% |
| Group Marketing Services | $295 - $427 | 234% |
| Guardian | $295 - $427 | 234% |
| Health America | $295 - $427 | 234% |
| Healthcare Management Admin | $295 - $427 | 234% |
| Healthez | $295 - $427 | 234% |
| Humana | $295 - $427 | 234% |
| Insight | $295 - $427 | 234% |
| Intercare | $295 - $427 | 234% |
| Jfp Benefit Management | $295 - $427 | 234% |
| Jp Farley Corporation | $295 - $427 | 234% |
| Key Benefit Administrator | $295 - $427 | 234% |
| Liberty Union Life Assurance Co | $295 - $427 | 234% |
| Lucent Health | $295 - $427 | 234% |
| Luminare Health | $295 - $427 | 234% |
| Luminare Health (Detroit) | $295 - $427 | 234% |
| Magnacare | $295 - $427 | 234% |
| Medben | $295 - $427 | 234% |
| Medcost | $295 - $427 | 234% |
| Mutual Health Services | $295 - $427 | 234% |
| Mutual Of Omaha | $295 - $427 | 234% |
| Ncas | $295 - $427 | 234% |
| Nippon Life Ins | $295 - $427 | 234% |
| Nova | $295 - $427 | 234% |
| Painters Union Insurance Fund | $295 - $427 | 234% |
| Physicians Mutual | $295 - $427 | 234% |
| Plumbers Local 98 Insurance Fund | $295 - $427 | 234% |
| Prairie States | $295 - $427 | 234% |
| Preferred One | $295 - $427 | 234% |
| Primary Physician Care | $295 - $427 | 234% |
| Professional Benefit Administrators | $295 - $427 | 234% |
| Siho Insurance Services | $295 - $427 | 234% |
| The Loomis Company | $295 - $427 | 234% |
| Unicare | $295 - $427 | 234% |
| Us Health And Life | $295 - $427 | 234% |
| Valenz | $295 - $427 | 234% |
| Western & Southern Financial Group | $295 - $427 | 234% |
| Wps | $295 - $427 | 234% |
| Cigna | $298 - $431 | 236% |
| Geha | $302 - $436 | 239% |
| Coventry | $303 - $439 | 240% |
| First Health | $303 - $439 | 240% |
| Medical Mutual | $320 | 253% |
| Meritain | $320 | 253% |
| Prime Health Services | $322 - $466 | 255% |
| Three Rivers Provider Network | $362 - $524 | 287% |
| 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 Oakland County | $402 - $582 | 318% |
| Cmh Washtenaw County | $402 - $582 | 318% |