CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Sanford Worthington Medical Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $332
Cash Discount Price: $482
vs. Medicare Baseline: 2.63x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Sanford Worthington Medical Center is $332. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $482. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.63x the Medicare baseline. Located in 1018 Sixth Avenue Po Box 997, Worthington, MN.

Cash / Self-Pay

$482

Average discount available for prompt cash payment at this facility.

Insurance Median

$332

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: $482 (382%)

Insurance Median: $332 (263%)

Cash: $482 (382% of Medicare)

Ins. Median: $332 (263% 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 263% of the Medicare baseline (a markup of 163%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Sanford Health Plan Align	$120	95%
Ucare	$128 - $471	101%
Aetna	$130 - $494	103%
Blue Cross Blue Shield	$130 - $271	103%
Health Partners	$130 - $428	103%
Medicare (plans)	$130	103%
UnitedHealthcare	$130 - $504	103%
Primewest	$132	105%
Sanford Health Plan	$234 - $275	185%
Security Health Plan	$332	263%
Medica	$538 - $576	426%
First Choice Health Network	$543	430%
Healthez	$543	430%
Multiplan	$543	430%

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 $482.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77067.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Sanford Worthington Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77067.
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.