CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Munson Healthcare Otsego Memorial Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $237
Cash Discount Price: $366
vs. Medicare Baseline: 1.51x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Munson Healthcare Otsego Memorial Hospital is $237. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $366. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.51x the Medicare baseline. Located in 825 N Center Ave, Gaylord, MI.

Cash / Self-Pay

$366

Average discount available for prompt cash payment at this facility.

Insurance Median

$237

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: $366 (233%)

Insurance Median: $237 (151%)

Cash: $366 (233% of Medicare)

Ins. Median: $237 (151% 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.

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
Blue Cross Blue Shield	$30 - $282	19%
Mclaren Health Plan	$30 - $379	19%
Meridian	$30 - $77	19%
Molina	$30 - $158	19%
Priority Health	$30 - $376	19%
UnitedHealthcare	$30 - $362	19%
Aetna	$46 - $366	29%
Blue Care Network	$46 - $147	29%
Hap (Health Alliance Plan)	$46 - $362	29%
Humana	$46 - $147	29%
Medicare (plans)	$46 - $147	29%
Michigan Amish Medical Board	$46 - $147	29%
Northern Michigan Mennonite Group	$46 - $147	29%
Asr Physicians Care Network	$69 - $362	44%
Cigna	$70 - $376	45%
Nomi Health	$73 - $362	47%
Employee Benefit Logistics	$78 - $249	50%
Hospice Of Michigan	$233 - $271	148%
Munson Hospice	$272 - $852	173%
Enterprise Group Planning/Employee Benefit Plan	$311 - $362	198%
Cofinity	$331 - $384	211%
Provider Network Of America/Hawaii Mainland Administrative Group Health	$331 - $384	211%
Three Rivers Provider Network	$331 - $384	211%

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 $366.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77066.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Munson Healthcare Otsego Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77066.
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.