CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Charlevoix Area Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $212
  • Cash Discount Price: $295
  • vs. Medicare Baseline: 1.35x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Charlevoix Area Hospital is $212. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $295. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.35x the Medicare baseline. Located in 14700 Lakeshore Drive, Charlevoix, MI.
Cash / Self-Pay
$295

Average discount available for prompt cash payment at this facility.

Insurance Median
$212

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: $295 (188%)
Insurance Median: $212 (135%)
Cash: $295 (188% of Medicare)
Ins. Median: $212 (135% 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.

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 - $325 19%
Mclaren Health Plan $30 - $328 19%
Meridian $30 - $103 19%
Priority Health $30 - $352 19%
UnitedHealthcare $30 - $306 19%
Aetna $46 - $318 29%
Blue Care Network $46 - $165 29%
Hap (Health Alliance Plan) $46 - $282 29%
Medicare (plans) $46 - $165 29%
Michigan Amish Medical Board $46 - $165 29%
Molina $46 - $179 29%
Northern Michigan Mennonite Group $46 - $165 29%
Asr Physicians Care Network $69 - $282 44%
Cigna $70 - $352 45%
Nomi Health $73 - $327 47%
Employee Benefits Logistics $78 - $281 50%
Hospice Of Michigan $205 - $211 131%
Provider Network Of America/Hma Group Health $205 - $299 131%
Enterprise Group Planning Employee Benefit Plan $274 - $282 175%
First Health/Coventry Health/Community Care Network $274 - $282 175%
Medical Cost Savings Solution $274 - $282 175%
Three Rivers Provider Network $291 - $299 185%
Iba Health And Life Assurance Company $315 - $324 201%
Cofinity $318 - $327 203%
Preferred Medical Claim Solutions $325 - $334 207%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 14700 Lakeshore Drive, Charlevoix, MI 49720
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Critical Access Hospitals