CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Promedica Monroe Regional Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $190
Cash Discount Price: $413
vs. Medicare Baseline: 1.50x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Promedica Monroe Regional Hospital is $190. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $413. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.50x the Medicare baseline. Located in 718 N Macomb St, Monroe, MI.

Cash / Self-Pay

$413

Average discount available for prompt cash payment at this facility.

Insurance Median

$190

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: $413 (327%)

Insurance Median: $190 (150%)

Cash: $413 (327% of Medicare)

Ins. Median: $190 (150% 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

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
Amerihealth	$36	29%
Meridian	$45	36%
Priority Health	$45 - $350	36%
Blue Cross Blue Shield	$47 - $357	37%
Aetna	$48 - $448	38%
Molina Healthcare Of Michigan	$48	38%
UnitedHealthcare	$49 - $516	39%
Paramount Healthcare Inc	$80 - $483	63%
Health Alliance Plan	$83 - $522	66%
Veterans Affairs	$83	66%
Humana	$84 - $119	67%
Frontpath	$153 - $369	121%
Encore Health Network	$445	352%
Health Ohio Network, Llc	$445	352%
Cofinity	$453	359%
Multiplan	$572	453%

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 $413.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77067.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Promedica Monroe Regional Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77067.
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.