CMS Price Transparency Data
Screening mammogram (both breasts)
Facility: Mercy Health Lakeshore Campus
Billing Code: 77067 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 77067
- Insurance Median: $279
- Cash Discount Price: $221
- vs. Medicare Baseline: 2.21x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Mercy Health Lakeshore Campus is $279. 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 2.21x the Medicare baseline. Located in 72 South State Street, Shelby, MI.
Cash / Self-Pay
$221
Average discount available for prompt cash payment at this facility.
Insurance Median
$279
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: $279 (221%)
Cash: $221 (175% of Medicare)
Ins. Median: $279 (221% 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 221% of the Medicare baseline (a markup of 121%). 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.
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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 | $61 - $314 | 48% |
| Medicaid / KanCare | $61 - $63 | 48% |
| Blue Care Network Advantage | $82 | 65% |
| Medicare (plans) | $82 | 65% |
| Access Health | $83 | 66% |
| Aetna | $83 - $292 | 66% |
| Align Senior Care | $83 | 66% |
| Correctional Recovery | $83 | 66% |
| Oscar | $83 | 66% |
| UnitedHealthcare | $83 - $330 | 66% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $94 | 74% |
| Vitalcore | $129 | 102% |
| Wellpath | $129 | 102% |
| Molina Marketplace | $130 - $153 | 103% |
| Hospice Of Michigan | $172 - $202 | 136% |
| Nomi Health | $175 - $206 | 139% |
| Hap | $234 - $337 | 185% |
| Wc Accident Fund | $246 - $289 | 195% |
| Wc Advantage | $246 - $289 | 195% |
| Wc Aig | $246 - $289 | 195% |
| Wc Allied | $246 - $289 | 195% |
| Wc Amerisure | $246 - $289 | 195% |
| Wc Amtrust | $246 - $289 | 195% |
| Wc Asu Risk Mgt | $246 - $289 | 195% |
| Wc Berkley Admin | $246 - $289 | 195% |
| Wc Broadspire | $246 - $289 | 195% |
| Wc Bunch & Associates | $246 - $289 | 195% |
| Wc Ccmsi | $246 - $289 | 195% |
| Wc Emc Insurance Company | $246 - $289 | 195% |
| Wc Esis | $246 - $289 | 195% |
| Wc Fcci | $246 - $289 | 195% |
| Wc Federated | $246 - $289 | 195% |
| Wc Gallagher Bassett | $246 - $289 | 195% |
| Wc Genex Care For Ohio | $246 - $289 | 195% |
| Wc Guard Insurance Company | $246 - $289 | 195% |
| Wc Hartford | $246 - $289 | 195% |
| Wc Liberty Mutual | $246 - $289 | 195% |
| Wc Meijers | $246 - $289 | 195% |
| Wc Michigan | $246 - $289 | 195% |
| Wc Mitchell Frankenmuth | $246 - $289 | 195% |
| Wc Pma | $246 - $289 | 195% |
| Wc Sedgwick | $246 - $289 | 195% |
| Wc Sentry | $246 - $289 | 195% |
| Wc Travelers | $246 - $289 | 195% |
| Wc Tristar | $246 - $289 | 195% |
| Wc Walmart | $246 - $289 | 195% |
| Wc Zurich | $246 - $289 | 195% |
| Geha | $248 - $330 | 196% |
| Meritain | $248 - $292 | 196% |
| Asr Health Benefits | $260 - $306 | 206% |
| Bcn Domestic | $267 - $314 | 211% |
| Blue Benefit Administrators Of Massachusetts | $267 - $314 | 211% |
| Blue Care Network | $267 - $314 | 211% |
| Blue Distinction Transplant | $267 - $314 | 211% |
| Blue Shield - Ca | $267 - $314 | 211% |
| Blue Shield - Id (Regence) | $267 - $314 | 211% |
| Blue Shield - Ny Highmark Northeastern | $267 - $314 | 211% |
| Blue Shield - Ny Highmark Western | $267 - $314 | 211% |
| Blue Shield - Pa (Highmark) | $267 - $314 | 211% |
| Blue Shield - Wa (Regence) | $267 - $314 | 211% |
| Health Choices | $267 - $328 | 211% |
| Kaiser Domestic | $267 - $314 | 211% |
| 1199 National Benefit Fund | $268 - $316 | 212% |
| Allied National Global Care | $268 - $316 | 212% |
| Asrm - Reliance Standard Life Insurance | $268 - $316 | 212% |
| Christian Care Ministry | $268 - $316 | 212% |
| Dean Health | $268 - $316 | 212% |
| Fallon Health | $268 - $316 | 212% |
| Family Life Insurance Company | $268 - $316 | 212% |
| Ghc Scw | $268 - $316 | 212% |
| Group Pension Administrators | $268 - $316 | 212% |
| International Benefit Administrators | $268 - $316 | 212% |
| Lifetime Benefit Solutions | $268 - $316 | 212% |
| Manhattan Life | $268 - $316 | 212% |
| Medi Share | $268 - $316 | 212% |
| Multiplan | $268 - $316 | 212% |
| Mvp | $268 - $316 | 212% |
| Pai | $268 - $316 | 212% |
| Pan-American Life | $268 - $316 | 212% |
| Paramount Hmo | $268 - $316 | 212% |
| Phcs | $268 - $316 | 212% |
| Trinity Health Share | $268 - $316 | 212% |
| Cigna | $271 - $319 | 215% |
| Caresource | $278 - $327 | 220% |
| Acclaim | $279 - $328 | 221% |
| Administrative Concepts | $279 - $328 | 221% |
| Allegeant | $279 - $328 | 221% |
| Allied Benefit Systems | $279 - $328 | 221% |
| Ameriben | $279 - $328 | 221% |
| American Family | $279 - $328 | 221% |
| American Healthcare Alliance | $279 - $328 | 221% |
| American Republic | $279 - $328 | 221% |
| Amerihealth | $279 - $328 | 221% |
| Aultcare | $279 - $328 | 221% |
| Automated Benefit Services | $279 - $328 | 221% |
| Auxiant | $279 - $328 | 221% |
| Benefit Administrative Systems,Llc | $279 - $328 | 221% |
| Boon Chapman | $279 - $328 | 221% |
| Cam Administrative Services | $279 - $328 | 221% |
| Christian Brother Services | $279 - $328 | 221% |
| Christian Brothers Holy Cross | $279 - $328 | 221% |
| Claimchoice Adminstrators | $279 - $328 | 221% |
| Comprehensive Benefits | $279 - $328 | 221% |
| Consociate | $279 - $328 | 221% |
| Continental Life Insurance | $279 - $328 | 221% |
| Custom Benefit Administrators | $279 - $328 | 221% |
| Cypress Benefit Administrators | $279 - $328 | 221% |
| Employee Benefit Concepts | $279 - $328 | 221% |
| Employee Benefit Management | $279 - $328 | 221% |
| Enterprise Group Planning | $279 - $328 | 221% |
| Forest County Potawatomi | $279 - $328 | 221% |
| Freedom Life Insurance Company | $279 - $328 | 221% |
| Group Administrators | $279 - $328 | 221% |
| Group Marketing Services | $279 - $328 | 221% |
| Guardian | $279 - $328 | 221% |
| Health America | $279 - $328 | 221% |
| Health Smart | $279 - $328 | 221% |
| Healthez | $279 - $328 | 221% |
| Healthgram | $279 - $328 | 221% |
| Healthscope | $279 - $328 | 221% |
| Humana | $279 - $328 | 221% |
| Insight | $279 - $328 | 221% |
| Intercare | $279 - $328 | 221% |
| Jfp Benefit Management | $279 - $328 | 221% |
| Jp Farley Corporation | $279 - $328 | 221% |
| Key Benefit Administrator | $279 - $328 | 221% |
| Liberty Union Life Assurance Co | $279 - $328 | 221% |
| Lucent Health | $279 - $328 | 221% |
| Luminare Health | $279 - $328 | 221% |
| Luminare Health (Detroit) | $279 - $328 | 221% |
| Medben | $279 - $328 | 221% |
| Medcost | $279 - $328 | 221% |
| Medical Mutual | $279 - $328 | 221% |
| Mutual Health Services | $279 - $328 | 221% |
| Mutual Of Omaha | $279 - $328 | 221% |
| Ncas | $279 - $328 | 221% |
| Nippon Life Ins | $279 - $328 | 221% |
| Nova | $279 - $328 | 221% |
| Painters Union Insurance Fund | $279 - $328 | 221% |
| Physicians Mutual | $279 - $328 | 221% |
| Plumbers Local 98 Insurance Fund | $279 - $328 | 221% |
| Prairie States | $279 - $328 | 221% |
| Primary Physician Care | $279 - $328 | 221% |
| Professional Benefit Administrators | $279 - $328 | 221% |
| Secureone Preferred United Plans | $279 - $328 | 221% |
| The Loomis Company | $279 - $328 | 221% |
| Trustmark Small Business Benefits | $279 - $328 | 221% |
| U Of M Health Plan | $279 - $328 | 221% |
| Unicare | $279 - $328 | 221% |
| Unified Group Services | $279 - $328 | 221% |
| Us Health And Life | $279 - $328 | 221% |
| Valenz | $279 - $328 | 221% |
| Varipro | $279 - $337 | 221% |
| Western & Southern Financial Group | $279 - $328 | 221% |
| Wps | $279 - $328 | 221% |
| Priority Health | $281 - $331 | 223% |
| First Health | $282 - $332 | 223% |