CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Chelsea Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $267
  • Cash Discount Price: $320
  • vs. Medicare Baseline: 2.11x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Chelsea Hospital is $267. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $320. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.11x the Medicare baseline. Located in 775 S Main St, Chelsea, MI.
Cash / Self-Pay
$320

Average discount available for prompt cash payment at this facility.

Insurance Median
$267

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: $320 (253%)
Insurance Median: $267 (211%)
Cash: $320 (253% of Medicare)
Ins. Median: $267 (211% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 211% of the Medicare baseline (a markup of 111%). 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.

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 $48 - $240 38%
Medicaid / KanCare $48 - $49 38%
Aetna $86 - $320 68%
Blue Care Network Advantage $86 68%
Medicare (plans) $86 - $88 68%
Align Senior Care $88 70%
Angela Hospice $88 70%
Arbor Hospice $88 70%
Heartland Hospice $88 70%
UnitedHealthcare $91 - $391 72%
Cca - Zing Health $93 74%
Longevity Ipa Of Michigan Llc Health Plan Isnp $99 78%
Wc Accident Fund $106 - $154 84%
Wc Advantage $106 - $154 84%
Wc Aig $106 - $154 84%
Wc Allied $106 - $154 84%
Wc Amerisure $106 - $154 84%
Wc Amtrust $106 - $154 84%
Wc Asu Risk Mgt $106 - $154 84%
Wc Berkley Admin $106 - $154 84%
Wc Broadspire $106 - $154 84%
Wc Bunch & Associates $106 - $154 84%
Wc Ccmsi $106 - $154 84%
Wc Emc Insurance Company $106 - $154 84%
Wc Esis $106 - $154 84%
Wc Fcci $106 - $154 84%
Wc Federated $106 - $154 84%
Wc Gallagher Bassett $106 - $154 84%
Wc Genex Care For Ohio $106 - $154 84%
Wc Guard Insurance Company $106 - $154 84%
Wc Hartford $106 - $154 84%
Wc Liberty Mutual $106 - $154 84%
Wc Meijers $106 - $154 84%
Wc Michigan $106 - $154 84%
Wc Mitchell Frankenmuth $106 - $154 84%
Wc Pma $106 - $154 84%
Wc Sedgwick $106 - $154 84%
Wc Sentry $106 - $154 84%
Wc Travelers $106 - $154 84%
Wc Tristar $106 - $154 84%
Wc Walmart $106 - $154 84%
Wc Zurich $106 - $154 84%
Molina Marketplace $115 91%
Vitalcore $129 102%
Health Cost Solutions $137 109%
Wellpath $137 109%
Priority Health $173 - $193 137%
Employee Benefit Logistic $199 158%
Asr Health Benefits $201 159%
Caresource $201 159%
Hap $201 - $452 159%
Varipro $201 159%
Bcn Domestic $240 190%
Blue Benefit Administrators Of Massachusetts $240 190%
Blue Care Network $240 190%
Blue Distinction Transplant $240 190%
Blue Shield - Ca $240 190%
Blue Shield - Id (Regence) $240 190%
Blue Shield - Ny Highmark Northeastern $240 190%
Blue Shield - Ny Highmark Western $240 190%
Blue Shield - Pa (Highmark) $240 190%
Blue Shield - Wa (Regence) $240 190%
Health Choices $240 - $387 190%
Kaiser Domestic $240 190%
Access Health $267 - $387 211%
Acclaim $267 - $387 211%
Administrative Concepts $267 - $387 211%
Allegeant $267 - $387 211%
Ameriben $267 - $387 211%
American Family $267 - $387 211%
American Healthcare Alliance $267 - $387 211%
American National $267 - $387 211%
American Republic $267 - $387 211%
Amerihealth $267 - $387 211%
Aultcare $267 - $387 211%
Automated Benefit Services $267 - $387 211%
Auxiant $267 - $387 211%
Benefit Administrative Systems,Llc $267 - $387 211%
Boon Chapman $267 - $387 211%
Cam Administrative Services $267 - $387 211%
Christian Brother Services $267 - $387 211%
Christian Brothers Holy Cross $267 - $387 211%
Comprehensive Benefits $267 - $387 211%
Continental Life Insurance $267 - $387 211%
Custom Benefit Administrators $267 - $387 211%
Employee Benefit Concepts $267 - $387 211%
Employee Benefit Management $267 - $387 211%
Enterprise Group Planning $267 - $387 211%
Freedom Life Insurance Company $267 - $387 211%
Group Administrators $267 - $387 211%
Group Marketing Services $267 - $387 211%
Guardian $267 - $387 211%
Health America $267 - $387 211%
Healthcare Management Admin $267 - $387 211%
Healthez $267 - $387 211%
Humana $267 - $387 211%
Insight $267 - $387 211%
Intercare $267 - $387 211%
Jfp Benefit Management $267 - $387 211%
Jp Farley Corporation $267 - $387 211%
Key Benefit Administrator $267 - $387 211%
Liberty Union Life Assurance Co $267 - $387 211%
Lucent Health $267 - $387 211%
Luminare Health $267 - $387 211%
Luminare Health (Detroit) $267 - $387 211%
Magnacare $267 - $387 211%
Medben $267 - $387 211%
Medcost $267 - $387 211%
Medical Mutual $267 - $387 211%
Mutual Health Services $267 - $387 211%
Mutual Of Omaha $267 - $387 211%
Ncas $267 - $387 211%
Nippon Life Ins $267 - $387 211%
Nova $267 - $387 211%
Painters Union Insurance Fund $267 - $387 211%
Physicians Mutual $267 - $387 211%
Plumbers Local 98 Insurance Fund $267 - $387 211%
Prairie States $267 - $387 211%
Preferred One $267 - $387 211%
Primary Physician Care $267 - $387 211%
Professional Benefit Administrators $267 - $387 211%
Siho Insurance Services $267 - $387 211%
Sisco Benefits $267 - $387 211%
The Loomis Company $267 - $387 211%
Unicare $267 - $387 211%
Us Health And Life $267 - $387 211%
Valenz $267 - $387 211%
Western & Southern Financial Group $267 - $387 211%
Wps $267 - $387 211%
Geha $270 - $391 214%
Coventry $275 - $398 218%
First Health $275 - $398 218%
U Of M Health Plan $280 222%
Hospice Of Michigan $281 - $407 223%
Cigna $284 - $411 225%
1199 National Benefit Fund $302 - $436 239%
Allied National Global Care $302 - $436 239%
Asrm - Reliance Standard Life Insurance $302 - $436 239%
Christian Care Ministry $302 - $436 239%
Dean Health $302 - $436 239%
Fallon Health $302 - $436 239%
Family Life Insurance Company $302 - $436 239%
Ghc Scw $302 - $436 239%
Group Pension Administrators $302 - $436 239%
International Benefit Administrators $302 - $436 239%
Lifetime Benefit Solutions $302 - $436 239%
Manhattan Life $302 - $436 239%
Medi Share $302 - $436 239%
Multiplan $302 - $436 239%
Mvp $302 - $436 239%
Pai $302 - $436 239%
Pan-American Life $302 - $436 239%
Paramount Hmo $302 - $436 239%
Phcs $302 - $436 239%
Trinity Health Share $302 - $436 239%
Health Partners $312 - $452 247%
Tufts Health Plan $312 - $452 247%
Meritain $320 253%
Prime Health Services $322 - $466 255%
Three Rivers Provider Network $362 - $524 287%
Cmh Detroit Wayne Integrated Health Network $402 - $582 318%
Cmh Jackson County/Lifeways $402 - $582 318%
Cmh Lenawee County $402 - $582 318%
Cmh Livingston County $402 - $582 318%
Cmh Misc $402 - $582 318%
Cmh Monroe County $402 - $582 318%
Cmh Washtenaw County $402 - $582 318%
Magellan Behavioral Health $402 - $582 318%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 775 S Main St, Chelsea, MI 48118
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals