CMS Price Transparency Data
Diagnostic mammogram (both breasts)
Facility: Mercy Health Saint Mary's
Billing Code: 77066 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 77066
- Insurance Median: $330
- Cash Discount Price: $294
- vs. Medicare Baseline: 2.10x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Mercy Health Saint Mary's is $330. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $294. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 2.10x the Medicare baseline. Located in 200 Jefferson Avenue Se, Grand Rapids, MI.
Cash / Self-Pay
$294
Average discount available for prompt cash payment at this facility.
Insurance Median
$330
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: $294 (187%)
Insurance Median: $330 (210%)
Cash: $294 (187% of Medicare)
Ins. Median: $330 (210% 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 210% of the Medicare baseline (a markup of 110%). 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 | $55 - $311 | 35% |
| Medicaid / KanCare | $55 - $56 | 35% |
| Access Health | $71 | 45% |
| Aetna | $99 - $386 | 63% |
| Blue Care Network Advantage | $99 | 63% |
| Medicare (plans) | $99 | 63% |
| Align Senior Care | $101 | 64% |
| Correctional Recovery | $101 | 64% |
| Hospice Faith | $101 | 64% |
| Hospice Of Holland | $101 | 64% |
| Oscar | $101 | 64% |
| UnitedHealthcare | $104 - $452 | 66% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $114 | 73% |
| Molina Marketplace | $131 | 83% |
| Vitalcore | $157 | 100% |
| Wellpath | $157 | 100% |
| Wc Accident Fund | $247 | 157% |
| Wc Advantage | $247 | 157% |
| Wc Aig | $247 | 157% |
| Wc Allied | $247 | 157% |
| Wc Amerisure | $247 | 157% |
| Wc Amtrust | $247 | 157% |
| Wc Asu Risk Mgt | $247 | 157% |
| Wc Berkley Admin | $247 | 157% |
| Wc Broadspire | $247 | 157% |
| Wc Bunch & Associates | $247 | 157% |
| Wc Ccmsi | $247 | 157% |
| Wc Emc Insurance Company | $247 | 157% |
| Wc Esis | $247 | 157% |
| Wc Fcci | $247 | 157% |
| Wc Federated | $247 | 157% |
| Wc Gallagher Bassett | $247 | 157% |
| Wc Genex Care For Ohio | $247 | 157% |
| Wc Guard Insurance Company | $247 | 157% |
| Wc Hartford | $247 | 157% |
| Wc Liberty Mutual | $247 | 157% |
| Wc Meijers | $247 | 157% |
| Wc Michigan | $247 | 157% |
| Wc Mitchell Frankenmuth | $247 | 157% |
| Wc Pma | $247 | 157% |
| Wc Sedgwick | $247 | 157% |
| Wc Sentry | $247 | 157% |
| Wc Travelers | $247 | 157% |
| Wc Tristar | $247 | 157% |
| Wc Walmart | $247 | 157% |
| Wc Zurich | $247 | 157% |
| Nomi Health | $253 | 161% |
| Acs Benefit Services | $260 | 166% |
| Allied Benefit Systems | $260 | 166% |
| Claimchoice Adminstrators | $260 | 166% |
| Consociate | $260 | 166% |
| Cypress Benefit Administrators | $260 | 166% |
| Forest County Potawatomi | $260 | 166% |
| Health Smart | $260 | 166% |
| Healthgram | $260 | 166% |
| Healthscope | $260 | 166% |
| Secureone Preferred United Plans | $260 | 166% |
| Sisco Benefits | $260 | 166% |
| The Health Plan | $260 | 166% |
| Trustmark Small Business Benefits | $260 | 166% |
| Unified Group Services | $260 | 166% |
| Webtpa | $260 | 166% |
| Asr Health Benefits | $288 | 183% |
| Hap | $288 - $350 | 183% |
| Varipro | $294 | 187% |
| Caresource | $295 | 188% |
| Bcn Domestic | $311 | 198% |
| Blue Benefit Administrators Of Massachusetts | $311 | 198% |
| Blue Care Network | $311 | 198% |
| Blue Distinction Transplant | $311 | 198% |
| Blue Shield - Ca | $311 | 198% |
| Blue Shield - Id (Regence) | $311 | 198% |
| Blue Shield - Ny Highmark Northeastern | $311 | 198% |
| Blue Shield - Ny Highmark Western | $311 | 198% |
| Blue Shield - Pa (Highmark) | $311 | 198% |
| Blue Shield - Wa (Regence) | $311 | 198% |
| Health Choices | $311 - $344 | 198% |
| Kaiser Domestic | $311 | 198% |
| 1199 National Benefit Fund | $330 | 210% |
| Allied National Global Care | $330 | 210% |
| Asrm - Reliance Standard Life Insurance | $330 | 210% |
| Christian Care Ministry | $330 | 210% |
| Cigna | $330 | 210% |
| Dean Health | $330 | 210% |
| Fallon Health | $330 | 210% |
| Family Life Insurance Company | $330 | 210% |
| Ghc Scw | $330 | 210% |
| Group Pension Administrators | $330 | 210% |
| International Benefit Administrators | $330 | 210% |
| Lifetime Benefit Solutions | $330 | 210% |
| Manhattan Life | $330 | 210% |
| Medi Share | $330 | 210% |
| Multiplan | $330 | 210% |
| Mvp | $330 | 210% |
| Pai | $330 | 210% |
| Pan-American Life | $330 | 210% |
| Paramount Hmo | $330 | 210% |
| Phcs | $330 | 210% |
| Trinity Health Share | $330 | 210% |
| Acclaim | $344 | 219% |
| Administrative Concepts | $344 | 219% |
| Allegeant | $344 | 219% |
| Ameriben | $344 | 219% |
| American Family | $344 | 219% |
| American Healthcare Alliance | $344 | 219% |
| American Republic | $344 | 219% |
| Amerihealth | $344 | 219% |
| Aultcare | $344 | 219% |
| Automated Benefit Services | $344 | 219% |
| Auxiant | $344 | 219% |
| Benefit Administrative Systems,Llc | $344 | 219% |
| Boon Chapman | $344 | 219% |
| Cam Administrative Services | $344 | 219% |
| Christian Brother Services | $344 | 219% |
| Christian Brothers Holy Cross | $344 | 219% |
| Comprehensive Benefits | $344 | 219% |
| Continental Life Insurance | $344 | 219% |
| Custom Benefit Administrators | $344 | 219% |
| Employee Benefit Concepts | $344 | 219% |
| Employee Benefit Management | $344 | 219% |
| Enterprise Group Planning | $344 | 219% |
| Freedom Life Insurance Company | $344 | 219% |
| Geha | $344 - $386 | 219% |
| Group Administrators | $344 | 219% |
| Group Marketing Services | $344 | 219% |
| Guardian | $344 | 219% |
| Health America | $344 | 219% |
| Healthez | $344 | 219% |
| Humana | $344 - $452 | 219% |
| Insight | $344 | 219% |
| Intercare | $344 | 219% |
| Jfp Benefit Management | $344 | 219% |
| Jp Farley Corporation | $344 | 219% |
| Key Benefit Administrator | $344 | 219% |
| Liberty Union Life Assurance Co | $344 | 219% |
| Lucent Health | $344 | 219% |
| Luminare Health | $344 | 219% |
| Luminare Health (Detroit) | $344 | 219% |
| Medben | $344 | 219% |
| Medcost | $344 | 219% |
| Mutual Health Services | $344 | 219% |
| Mutual Of Omaha | $344 | 219% |
| Ncas | $344 | 219% |
| Nippon Life Ins | $344 | 219% |
| Nova | $344 | 219% |
| Painters Union Insurance Fund | $344 | 219% |
| Physicians Mutual | $344 | 219% |
| Plumbers Local 98 Insurance Fund | $344 | 219% |
| Prairie States | $344 | 219% |
| Primary Physician Care | $344 | 219% |
| Professional Benefit Administrators | $344 | 219% |
| The Loomis Company | $344 | 219% |
| U Of M Health Plan | $344 - $346 | 219% |
| Unicare | $344 | 219% |
| Us Health And Life | $344 | 219% |
| Valenz | $344 | 219% |
| Western & Southern Financial Group | $344 | 219% |
| Wps | $344 | 219% |
| Priority Health | $347 - $350 | 221% |
| Coventry | $358 | 228% |
| First Health | $358 | 228% |
| Medical Mutual | $386 | 246% |
| Meritain | $386 | 246% |
| Preferred One | $386 | 246% |
| Cmh Allegan County | $452 | 288% |
| Cmh Ausable Valley | $452 | 288% |
| Cmh Barry County | $452 | 288% |
| Cmh Berrien County | $452 | 288% |
| Cmh Cass County | $452 | 288% |
| Cmh Clinton-Eaton-Ingham County | $452 | 288% |
| Cmh Kalamazoo | $452 | 288% |
| Cmh Kent County | $452 | 288% |
| Cmh Lenawee County | $452 | 288% |
| Cmh Misc | $452 | 288% |
| Cmh Monroe County | $452 | 288% |
| Cmh Montcalm County | $452 | 288% |
| Cmh Muskegon County | $452 | 288% |
| Cmh Newaygo County | $452 | 288% |
| Cmh North Country | $452 | 288% |
| Cmh Northern Lakes County | $452 | 288% |
| Cmh Ottawa County | $452 | 288% |
| Cmh Van Buren County | $452 | 288% |
| Cmh West Mi County | $452 | 288% |
| Magellan Behavioral Health | $452 | 288% |