CMS Price Transparency Data
Screening mammogram (both breasts)
Facility: Trinity Health Muskegon Hospital
Billing Code: 77067 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 77067
- Insurance Median: $246
- Cash Discount Price: $221
- vs. Medicare Baseline: 1.95x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Trinity Health Muskegon Hospital is $246. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $221. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.95x the Medicare baseline. Located in 1500 E Sherman Blvd, Muskegon, MI.
Cash / Self-Pay
$221
Average discount available for prompt cash payment at this facility.
Insurance Median
$246
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: $221 (175%)
Insurance Median: $246 (195%)
Cash: $221 (175% of Medicare)
Ins. Median: $246 (195% 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.
Out-of-Pocket Cost Estimator
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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 | $46 - $251 | 36% |
| Medicaid / KanCare | $46 | 36% |
| Access Health | $58 | 46% |
| Aetna | $82 - $320 | 65% |
| Blue Care Network Advantage | $82 | 65% |
| Medicare (plans) | $82 | 65% |
| Align Senior Care | $83 | 66% |
| Correctional Recovery | $83 | 66% |
| Heartland Hospice | $83 | 66% |
| Hospice Harbor Hospice | $83 | 66% |
| Oscar | $83 | 66% |
| UnitedHealthcare | $86 - $323 | 68% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $94 | 74% |
| Molina Marketplace | $108 | 86% |
| Vitalcore | $129 | 102% |
| Wellpath | $129 | 102% |
| Acs Benefit Services | $162 - $191 | 128% |
| Allied Benefit Systems | $162 - $191 | 128% |
| Claimchoice Adminstrators | $162 - $191 | 128% |
| Consociate | $162 - $191 | 128% |
| Cypress Benefit Administrators | $162 - $191 | 128% |
| Forest County Potawatomi | $162 - $191 | 128% |
| Health Smart | $162 - $191 | 128% |
| Healthgram | $162 - $191 | 128% |
| Healthscope | $162 - $191 | 128% |
| Preferred One | $162 - $191 | 128% |
| Secureone Preferred United Plans | $162 - $191 | 128% |
| Sisco Benefits | $162 - $191 | 128% |
| The Health Plan | $162 - $191 | 128% |
| Trustmark Small Business Benefits | $162 - $191 | 128% |
| Unified Group Services | $162 - $191 | 128% |
| Webtpa | $162 - $191 | 128% |
| Asr Health Benefits | $166 - $195 | 131% |
| Hap | $166 - $291 | 131% |
| Wc Accident Fund | $166 - $196 | 131% |
| Wc Advantage | $166 - $196 | 131% |
| Wc Aig | $166 - $196 | 131% |
| Wc Allied | $166 - $196 | 131% |
| Wc Amerisure | $166 - $196 | 131% |
| Wc Amtrust | $166 - $196 | 131% |
| Wc Asu Risk Mgt | $166 - $196 | 131% |
| Wc Berkley Admin | $166 - $196 | 131% |
| Wc Broadspire | $166 - $196 | 131% |
| Wc Bunch & Associates | $166 - $196 | 131% |
| Wc Ccmsi | $166 - $196 | 131% |
| Wc Emc Insurance Company | $166 - $196 | 131% |
| Wc Esis | $166 - $196 | 131% |
| Wc Fcci | $166 - $196 | 131% |
| Wc Federated | $166 - $196 | 131% |
| Wc Gallagher Bassett | $166 - $196 | 131% |
| Wc Genex Care For Ohio | $166 - $196 | 131% |
| Wc Guard Insurance Company | $166 - $196 | 131% |
| Wc Hartford | $166 - $196 | 131% |
| Wc Liberty Mutual | $166 - $196 | 131% |
| Wc Meijers | $166 - $196 | 131% |
| Wc Michigan | $166 - $196 | 131% |
| Wc Mitchell Frankenmuth | $166 - $196 | 131% |
| Wc Pma | $166 - $196 | 131% |
| Wc Sedgwick | $166 - $196 | 131% |
| Wc Sentry | $166 - $196 | 131% |
| Wc Travelers | $166 - $196 | 131% |
| Wc Tristar | $166 - $196 | 131% |
| Wc Walmart | $166 - $196 | 131% |
| Wc Zurich | $166 - $196 | 131% |
| Hospice Of Michigan | $172 - $202 | 136% |
| Nomi Health | $175 - $206 | 139% |
| Varipro | $181 - $212 | 143% |
| Caresource | $196 - $231 | 155% |
| Cigna | $196 - $231 | 155% |
| Priority Health | $204 - $227 | 162% |
| 1199 National Benefit Fund | $234 - $275 | 185% |
| Allied National Global Care | $234 - $275 | 185% |
| Asrm - Reliance Standard Life Insurance | $234 - $275 | 185% |
| Christian Care Ministry | $234 - $275 | 185% |
| Dean Health | $234 - $275 | 185% |
| Fallon Health | $234 - $275 | 185% |
| Family Life Insurance Company | $234 - $275 | 185% |
| Ghc Scw | $234 - $275 | 185% |
| Group Pension Administrators | $234 - $275 | 185% |
| International Benefit Administrators | $234 - $275 | 185% |
| Lifetime Benefit Solutions | $234 - $275 | 185% |
| Manhattan Life | $234 - $275 | 185% |
| Medi Share | $234 - $275 | 185% |
| Multiplan | $234 - $275 | 185% |
| Mvp | $234 - $275 | 185% |
| Pai | $234 - $275 | 185% |
| Pan-American Life | $234 - $275 | 185% |
| Paramount Hmo | $234 - $275 | 185% |
| Phcs | $234 - $275 | 185% |
| Trinity Health Share | $234 - $275 | 185% |
| Acclaim | $246 - $289 | 195% |
| Administrative Concepts | $246 - $289 | 195% |
| Allegeant | $246 - $289 | 195% |
| Ameriben | $246 - $289 | 195% |
| American Family | $246 - $289 | 195% |
| American Healthcare Alliance | $246 - $289 | 195% |
| American Republic | $246 - $289 | 195% |
| Amerihealth | $246 - $289 | 195% |
| Aultcare | $246 - $289 | 195% |
| Automated Benefit Services | $246 - $289 | 195% |
| Auxiant | $246 - $289 | 195% |
| Benefit Administrative Systems,Llc | $246 - $289 | 195% |
| Boon Chapman | $246 - $289 | 195% |
| Cam Administrative Services | $246 - $289 | 195% |
| Christian Brother Services | $246 - $289 | 195% |
| Christian Brothers Holy Cross | $246 - $289 | 195% |
| Comprehensive Benefits | $246 - $289 | 195% |
| Continental Life Insurance | $246 - $289 | 195% |
| Custom Benefit Administrators | $246 - $289 | 195% |
| Employee Benefit Concepts | $246 - $289 | 195% |
| Employee Benefit Management | $246 - $289 | 195% |
| Enterprise Group Planning | $246 - $289 | 195% |
| Freedom Life Insurance Company | $246 - $289 | 195% |
| Group Administrators | $246 - $289 | 195% |
| Group Marketing Services | $246 - $289 | 195% |
| Guardian | $246 - $289 | 195% |
| Health America | $246 - $289 | 195% |
| Health Choices | $246 - $289 | 195% |
| Healthez | $246 - $289 | 195% |
| Humana | $246 - $289 | 195% |
| Insight | $246 - $289 | 195% |
| Intercare | $246 - $289 | 195% |
| Jfp Benefit Management | $246 - $289 | 195% |
| Jp Farley Corporation | $246 - $289 | 195% |
| Key Benefit Administrator | $246 - $289 | 195% |
| Liberty Union Life Assurance Co | $246 - $289 | 195% |
| Lucent Health | $246 - $289 | 195% |
| Luminare Health | $246 - $289 | 195% |
| Luminare Health (Detroit) | $246 - $289 | 195% |
| Medben | $246 - $289 | 195% |
| Medcost | $246 - $289 | 195% |
| Medical Mutual | $246 - $289 | 195% |
| Mutual Health Services | $246 - $289 | 195% |
| Mutual Of Omaha | $246 - $289 | 195% |
| Ncas | $246 - $289 | 195% |
| Nippon Life Ins | $246 - $289 | 195% |
| Nova | $246 - $289 | 195% |
| Painters Union Insurance Fund | $246 - $289 | 195% |
| Physicians Mutual | $246 - $289 | 195% |
| Plumbers Local 98 Insurance Fund | $246 - $289 | 195% |
| Prairie States | $246 - $289 | 195% |
| Primary Physician Care | $246 - $289 | 195% |
| Professional Benefit Administrators | $246 - $289 | 195% |
| The Loomis Company | $246 - $289 | 195% |
| U Of M Health Plan | $246 - $289 | 195% |
| Unicare | $246 - $289 | 195% |
| Us Health And Life | $246 - $289 | 195% |
| Valenz | $246 - $289 | 195% |
| Western & Southern Financial Group | $246 - $289 | 195% |
| Wps | $246 - $289 | 195% |
| Bcn Domestic | $251 | 199% |
| Blue Benefit Administrators Of Massachusetts | $251 | 199% |
| Blue Care Network | $251 | 199% |
| Blue Distinction Transplant | $251 | 199% |
| Blue Shield - Ca | $251 | 199% |
| Blue Shield - Id (Regence) | $251 | 199% |
| Blue Shield - Ny Highmark Northeastern | $251 | 199% |
| Blue Shield - Ny Highmark Western | $251 | 199% |
| Blue Shield - Pa (Highmark) | $251 | 199% |
| Blue Shield - Wa (Regence) | $251 | 199% |
| Kaiser Domestic | $251 | 199% |
| First Health | $256 - $301 | 203% |
| Geha | $275 - $323 | 218% |
| Barinet | $312 - $367 | 247% |
| Cmh Allegan County | $312 - $367 | 247% |
| Cmh Barry County | $312 - $367 | 247% |
| Cmh Berrien County | $312 - $367 | 247% |
| Cmh Cass County | $312 - $367 | 247% |
| Cmh Kalamazoo | $312 - $367 | 247% |
| Cmh Kent County | $312 - $367 | 247% |
| Cmh Misc | $312 - $367 | 247% |
| Cmh Muskegon County | $312 - $367 | 247% |
| Cmh North Country | $312 - $367 | 247% |
| Cmh Northern Lakes County | $312 - $367 | 247% |
| Cmh Ottawa County | $312 - $367 | 247% |
| Cmh Van Buren County | $312 - $367 | 247% |
| Cmh West Mi County | $312 - $367 | 247% |
| Meritain | $320 | 253% |