CMS Price Transparency Data
Diagnostic mammogram (both breasts)
Facility: Trinity Health Muskegon Hospital
Billing Code: 77066 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 77066
- Insurance Median: $339
- Cash Discount Price: $294
- vs. Medicare Baseline: 2.16x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Trinity Health Muskegon Hospital is $339. 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 2.16x the Medicare baseline. Located in 1500 E Sherman Blvd, Muskegon, MI.
Cash / Self-Pay
$294
Average discount available for prompt cash payment at this facility.
Insurance Median
$339
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: $339 (216%)
Cash: $294 (187% of Medicare)
Ins. Median: $339 (216% 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 216% of the Medicare baseline (a markup of 116%). 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 - $304 | 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% |
| Heartland Hospice | $101 | 64% |
| Hospice Harbor Hospice | $101 | 64% |
| Oscar | $101 | 64% |
| UnitedHealthcare | $104 - $398 | 66% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $114 | 73% |
| Molina Marketplace | $131 | 83% |
| Vitalcore | $157 | 100% |
| Wellpath | $157 | 100% |
| Acs Benefit Services | $235 | 150% |
| Allied Benefit Systems | $235 | 150% |
| Claimchoice Adminstrators | $235 | 150% |
| Consociate | $235 | 150% |
| Cypress Benefit Administrators | $235 | 150% |
| Forest County Potawatomi | $235 | 150% |
| Health Smart | $235 | 150% |
| Healthgram | $235 | 150% |
| Healthscope | $235 | 150% |
| Preferred One | $235 | 150% |
| Secureone Preferred United Plans | $235 | 150% |
| Sisco Benefits | $235 | 150% |
| The Health Plan | $235 | 150% |
| Trustmark Small Business Benefits | $235 | 150% |
| Unified Group Services | $235 | 150% |
| Webtpa | $235 | 150% |
| Asr Health Benefits | $240 | 153% |
| Hap | $240 - $358 | 153% |
| Wc Accident Fund | $241 | 154% |
| Wc Advantage | $241 | 154% |
| Wc Aig | $241 | 154% |
| Wc Allied | $241 | 154% |
| Wc Amerisure | $241 | 154% |
| Wc Amtrust | $241 | 154% |
| Wc Asu Risk Mgt | $241 | 154% |
| Wc Berkley Admin | $241 | 154% |
| Wc Broadspire | $241 | 154% |
| Wc Bunch & Associates | $241 | 154% |
| Wc Ccmsi | $241 | 154% |
| Wc Emc Insurance Company | $241 | 154% |
| Wc Esis | $241 | 154% |
| Wc Fcci | $241 | 154% |
| Wc Federated | $241 | 154% |
| Wc Gallagher Bassett | $241 | 154% |
| Wc Genex Care For Ohio | $241 | 154% |
| Wc Guard Insurance Company | $241 | 154% |
| Wc Hartford | $241 | 154% |
| Wc Liberty Mutual | $241 | 154% |
| Wc Meijers | $241 | 154% |
| Wc Michigan | $241 | 154% |
| Wc Mitchell Frankenmuth | $241 | 154% |
| Wc Pma | $241 | 154% |
| Wc Sedgwick | $241 | 154% |
| Wc Sentry | $241 | 154% |
| Wc Travelers | $241 | 154% |
| Wc Tristar | $241 | 154% |
| Wc Walmart | $241 | 154% |
| Wc Zurich | $241 | 154% |
| Hospice Of Michigan | $249 | 159% |
| Nomi Health | $253 | 161% |
| Priority Health | $262 - $292 | 167% |
| Varipro | $262 | 167% |
| Caresource | $284 | 181% |
| Cigna | $284 | 181% |
| Bcn Domestic | $304 | 194% |
| Blue Benefit Administrators Of Massachusetts | $304 | 194% |
| Blue Care Network | $304 | 194% |
| Blue Distinction Transplant | $304 | 194% |
| Blue Shield - Ca | $304 | 194% |
| Blue Shield - Id (Regence) | $304 | 194% |
| Blue Shield - Ny Highmark Northeastern | $304 | 194% |
| Blue Shield - Ny Highmark Western | $304 | 194% |
| Blue Shield - Pa (Highmark) | $304 | 194% |
| Blue Shield - Wa (Regence) | $304 | 194% |
| Health Choices | $304 - $356 | 194% |
| Kaiser Domestic | $304 | 194% |
| 1199 National Benefit Fund | $339 | 216% |
| Allied National Global Care | $339 | 216% |
| Asrm - Reliance Standard Life Insurance | $339 | 216% |
| Christian Care Ministry | $339 | 216% |
| Dean Health | $339 | 216% |
| Fallon Health | $339 | 216% |
| Family Life Insurance Company | $339 | 216% |
| Ghc Scw | $339 | 216% |
| Group Pension Administrators | $339 | 216% |
| International Benefit Administrators | $339 | 216% |
| Lifetime Benefit Solutions | $339 | 216% |
| Manhattan Life | $339 | 216% |
| Medi Share | $339 | 216% |
| Multiplan | $339 | 216% |
| Mvp | $339 | 216% |
| Pai | $339 | 216% |
| Pan-American Life | $339 | 216% |
| Paramount Hmo | $339 | 216% |
| Phcs | $339 | 216% |
| Trinity Health Share | $339 | 216% |
| U Of M Health Plan | $346 - $356 | 220% |
| Acclaim | $356 | 227% |
| Administrative Concepts | $356 | 227% |
| Allegeant | $356 | 227% |
| Ameriben | $356 | 227% |
| American Family | $356 | 227% |
| American Healthcare Alliance | $356 | 227% |
| American Republic | $356 | 227% |
| Amerihealth | $356 | 227% |
| Aultcare | $356 | 227% |
| Automated Benefit Services | $356 | 227% |
| Auxiant | $356 | 227% |
| Benefit Administrative Systems,Llc | $356 | 227% |
| Boon Chapman | $356 | 227% |
| Cam Administrative Services | $356 | 227% |
| Christian Brother Services | $356 | 227% |
| Christian Brothers Holy Cross | $356 | 227% |
| Comprehensive Benefits | $356 | 227% |
| Continental Life Insurance | $356 | 227% |
| Custom Benefit Administrators | $356 | 227% |
| Employee Benefit Concepts | $356 | 227% |
| Employee Benefit Management | $356 | 227% |
| Enterprise Group Planning | $356 | 227% |
| Freedom Life Insurance Company | $356 | 227% |
| Group Administrators | $356 | 227% |
| Group Marketing Services | $356 | 227% |
| Guardian | $356 | 227% |
| Health America | $356 | 227% |
| Healthez | $356 | 227% |
| Humana | $356 | 227% |
| Insight | $356 | 227% |
| Intercare | $356 | 227% |
| Jfp Benefit Management | $356 | 227% |
| Jp Farley Corporation | $356 | 227% |
| Key Benefit Administrator | $356 | 227% |
| Liberty Union Life Assurance Co | $356 | 227% |
| Lucent Health | $356 | 227% |
| Luminare Health | $356 | 227% |
| Luminare Health (Detroit) | $356 | 227% |
| Medben | $356 | 227% |
| Medcost | $356 | 227% |
| Medical Mutual | $356 | 227% |
| Mutual Health Services | $356 | 227% |
| Mutual Of Omaha | $356 | 227% |
| Ncas | $356 | 227% |
| Nippon Life Ins | $356 | 227% |
| Nova | $356 | 227% |
| Painters Union Insurance Fund | $356 | 227% |
| Physicians Mutual | $356 | 227% |
| Plumbers Local 98 Insurance Fund | $356 | 227% |
| Prairie States | $356 | 227% |
| Primary Physician Care | $356 | 227% |
| Professional Benefit Administrators | $356 | 227% |
| The Loomis Company | $356 | 227% |
| Unicare | $356 | 227% |
| Us Health And Life | $356 | 227% |
| Valenz | $356 | 227% |
| Western & Southern Financial Group | $356 | 227% |
| Wps | $356 | 227% |
| First Health | $371 | 236% |
| Geha | $386 - $398 | 246% |
| Meritain | $386 | 246% |
| Barinet | $452 | 288% |
| Cmh Allegan County | $452 | 288% |
| Cmh Barry County | $452 | 288% |
| Cmh Berrien County | $452 | 288% |
| Cmh Cass County | $452 | 288% |
| Cmh Kalamazoo | $452 | 288% |
| Cmh Kent County | $452 | 288% |
| Cmh Misc | $452 | 288% |
| Cmh Muskegon 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% |