CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Sanford Wheaton Medical Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $473
Cash Discount Price: $453
vs. Medicare Baseline: 3.75x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Sanford Wheaton Medical Center is $473. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $453. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 3.75x the Medicare baseline. Located in 401 12Th Street North, Wheaton, MN.

Cash / Self-Pay

$453

Average discount available for prompt cash payment at this facility.

Insurance Median

$473

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: $453 (359%)

Insurance Median: $473 (375%)

Cash: $453 (359% of Medicare)

Ins. Median: $473 (375% 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 375% of the Medicare baseline (a markup of 275%). 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
Blue Cross Blue Shield	$165 - $390	131%
Sanford Health Plan Align	$285	226%
Ucare	$306 - $497	242%
Aetna	$309 - $492	245%
Health Partners	$309 - $458	245%
Medicare (plans)	$309	245%
UnitedHealthcare	$309 - $473	245%
Security Health Plan	$311	246%
Primewest	$315 - $342	250%
Sanford Health Plan	$447 - $526	354%
Medica	$498 - $535	394%
First Choice Health Network	$509	403%
Healthez	$509	403%
Multiplan	$509	403%

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 $453.
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 Wheaton 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.