CMS Price Transparency Data
Diagnostic mammogram (both breasts)
Facility: Mercy Health Lakeshore Campus
Billing Code: 77066 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 77066
- Insurance Median: $389
- Cash Discount Price: $294
- vs. Medicare Baseline: 2.48x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Mercy Health Lakeshore Campus is $389. 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 2.48x the Medicare baseline. Located in 72 South State Street, Shelby, MI.
Cash / Self-Pay
$294
Average discount available for prompt cash payment at this facility.
Insurance Median
$389
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: $389 (248%)
Cash: $294 (187% of Medicare)
Ins. Median: $389 (248% 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 248% of the Medicare baseline (a markup of 148%). 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 | $75 - $386 | 48% |
| Medicaid / KanCare | $75 - $76 | 48% |
| Access Health | $79 | 50% |
| Blue Care Network Advantage | $111 | 71% |
| Medicare (plans) | $111 | 71% |
| Aetna | $113 - $360 | 72% |
| Align Senior Care | $113 | 72% |
| Correctional Recovery | $113 | 72% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $127 | 81% |
| Oscar | $139 | 89% |
| Vitalcore | $151 | 96% |
| Wellpath | $157 | 100% |
| UnitedHealthcare | $158 - $407 | 101% |
| Molina Marketplace | $188 | 120% |
| Hospice Of Michigan | $249 | 159% |
| Nomi Health | $253 | 161% |
| Hap | $339 - $415 | 216% |
| U Of M Health Plan | $346 - $405 | 220% |
| Wc Accident Fund | $356 | 227% |
| Wc Advantage | $356 | 227% |
| Wc Aig | $356 | 227% |
| Wc Allied | $356 | 227% |
| Wc Amerisure | $356 | 227% |
| Wc Amtrust | $356 | 227% |
| Wc Asu Risk Mgt | $356 | 227% |
| Wc Berkley Admin | $356 | 227% |
| Wc Broadspire | $356 | 227% |
| Wc Bunch & Associates | $356 | 227% |
| Wc Ccmsi | $356 | 227% |
| Wc Emc Insurance Company | $356 | 227% |
| Wc Esis | $356 | 227% |
| Wc Fcci | $356 | 227% |
| Wc Federated | $356 | 227% |
| Wc Gallagher Bassett | $356 | 227% |
| Wc Genex Care For Ohio | $356 | 227% |
| Wc Guard Insurance Company | $356 | 227% |
| Wc Hartford | $356 | 227% |
| Wc Liberty Mutual | $356 | 227% |
| Wc Meijers | $356 | 227% |
| Wc Michigan | $356 | 227% |
| Wc Mitchell Frankenmuth | $356 | 227% |
| Wc Pma | $356 | 227% |
| Wc Sedgwick | $356 | 227% |
| Wc Sentry | $356 | 227% |
| Wc Travelers | $356 | 227% |
| Wc Tristar | $356 | 227% |
| Wc Walmart | $356 | 227% |
| Wc Zurich | $356 | 227% |
| Geha | $360 - $407 | 229% |
| Meritain | $360 | 229% |
| Asr Health Benefits | $376 | 240% |
| Bcn Domestic | $386 | 246% |
| Blue Benefit Administrators Of Massachusetts | $386 | 246% |
| Blue Care Network | $386 | 246% |
| Blue Distinction Transplant | $386 | 246% |
| Blue Shield - Ca | $386 | 246% |
| Blue Shield - Id (Regence) | $386 | 246% |
| Blue Shield - Ny Highmark Northeastern | $386 | 246% |
| Blue Shield - Ny Highmark Western | $386 | 246% |
| Blue Shield - Pa (Highmark) | $386 | 246% |
| Blue Shield - Wa (Regence) | $386 | 246% |
| Health Choices | $386 - $405 | 246% |
| Kaiser Domestic | $386 | 246% |
| 1199 National Benefit Fund | $389 | 248% |
| Allied National Global Care | $389 | 248% |
| Asrm - Reliance Standard Life Insurance | $389 | 248% |
| Christian Care Ministry | $389 | 248% |
| Dean Health | $389 | 248% |
| Fallon Health | $389 | 248% |
| Family Life Insurance Company | $389 | 248% |
| Ghc Scw | $389 | 248% |
| Group Pension Administrators | $389 | 248% |
| International Benefit Administrators | $389 | 248% |
| Lifetime Benefit Solutions | $389 | 248% |
| Manhattan Life | $389 | 248% |
| Medi Share | $389 | 248% |
| Multiplan | $389 | 248% |
| Mvp | $389 | 248% |
| Pai | $389 | 248% |
| Pan-American Life | $389 | 248% |
| Paramount Hmo | $389 | 248% |
| Phcs | $389 | 248% |
| Trinity Health Share | $389 | 248% |
| Cigna | $392 | 250% |
| Caresource | $403 | 257% |
| Acclaim | $405 | 258% |
| Administrative Concepts | $405 | 258% |
| Allegeant | $405 | 258% |
| Allied Benefit Systems | $405 | 258% |
| Ameriben | $405 | 258% |
| American Family | $405 | 258% |
| American Healthcare Alliance | $405 | 258% |
| American Republic | $405 | 258% |
| Amerihealth | $405 | 258% |
| Aultcare | $405 | 258% |
| Automated Benefit Services | $405 | 258% |
| Auxiant | $405 | 258% |
| Benefit Administrative Systems,Llc | $405 | 258% |
| Boon Chapman | $405 | 258% |
| Cam Administrative Services | $405 | 258% |
| Christian Brother Services | $405 | 258% |
| Christian Brothers Holy Cross | $405 | 258% |
| Claimchoice Adminstrators | $405 | 258% |
| Comprehensive Benefits | $405 | 258% |
| Consociate | $405 | 258% |
| Continental Life Insurance | $405 | 258% |
| Custom Benefit Administrators | $405 | 258% |
| Cypress Benefit Administrators | $405 | 258% |
| Employee Benefit Concepts | $405 | 258% |
| Employee Benefit Management | $405 | 258% |
| Enterprise Group Planning | $405 | 258% |
| Forest County Potawatomi | $405 | 258% |
| Freedom Life Insurance Company | $405 | 258% |
| Group Administrators | $405 | 258% |
| Group Marketing Services | $405 | 258% |
| Guardian | $405 | 258% |
| Health America | $405 | 258% |
| Health Smart | $405 | 258% |
| Healthez | $405 | 258% |
| Healthgram | $405 | 258% |
| Healthscope | $405 | 258% |
| Humana | $405 | 258% |
| Insight | $405 | 258% |
| Intercare | $405 | 258% |
| Jfp Benefit Management | $405 | 258% |
| Jp Farley Corporation | $405 | 258% |
| Key Benefit Administrator | $405 | 258% |
| Liberty Union Life Assurance Co | $405 | 258% |
| Lucent Health | $405 | 258% |
| Luminare Health | $405 | 258% |
| Luminare Health (Detroit) | $405 | 258% |
| Medben | $405 | 258% |
| Medcost | $405 | 258% |
| Medical Mutual | $405 | 258% |
| Mutual Health Services | $405 | 258% |
| Mutual Of Omaha | $405 | 258% |
| Ncas | $405 | 258% |
| Nippon Life Ins | $405 | 258% |
| Nova | $405 | 258% |
| Painters Union Insurance Fund | $405 | 258% |
| Physicians Mutual | $405 | 258% |
| Plumbers Local 98 Insurance Fund | $405 | 258% |
| Prairie States | $405 | 258% |
| Primary Physician Care | $405 | 258% |
| Professional Benefit Administrators | $405 | 258% |
| Secureone Preferred United Plans | $405 | 258% |
| The Loomis Company | $405 | 258% |
| Trustmark Small Business Benefits | $405 | 258% |
| Unicare | $405 | 258% |
| Unified Group Services | $405 | 258% |
| Us Health And Life | $405 | 258% |
| Valenz | $405 | 258% |
| Varipro | $405 - $415 | 258% |
| Western & Southern Financial Group | $405 | 258% |
| Wps | $405 | 258% |
| Priority Health | $407 | 259% |
| First Health | $409 | 261% |