CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Essentia Health Holy Trinity Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $335
  • Cash Discount Price: $400
  • vs. Medicare Baseline: 2.13x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Essentia Health Holy Trinity Hospital is $335. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $400. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 2.13x the Medicare baseline. Located in 115 Second Street West, Box 157, Graceville, MN.
Cash / Self-Pay
$400

Average discount available for prompt cash payment at this facility.

Insurance Median
$335

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: $400 (255%)
Insurance Median: $335 (213%)
Cash: $400 (255% of Medicare)
Ins. Median: $335 (213% 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 213% of the Medicare baseline (a markup of 113%). 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
Itasca Med Care $111 71%
Primewest $114 73%
Healthpartners Care Pmap $210 134%
Medica Access $215 137%
Sanford Healthplan $232 - $244 148%
Blue Cross Blue Shield $289 - $472 184%
Healthpartners $329 - $360 210%
Advocare/Security Health $335 213%
Freedom Blue Ppo $335 213%
Healthpartners Care Msho / Mcr Adv $335 213%
Imcare Msho Pcc Prime $335 213%
Imcare Msho Ref Req $335 213%
Medica Advantage Solutions $335 213%
Medica Msho/Dual Solutions $335 213%
Medica Prime Solution Group $335 213%
Medicare (plans) $335 213%
Nd Va Administration $335 213%
Platinum Blue/Vantage Blue $335 213%
Primewest Msho $335 213%
Secure Blue Msho $335 213%
Ubh Cost Plan $335 213%
Ubh Msho $335 213%
Ucare Msho $335 213%
UnitedHealthcare $335 - $490 213%
Ucare $356 227%
Cigna $360 229%
Healthpartners Pcc Prime $360 229%
Wea $390 - $417 248%
America'S Ppo $419 267%
Medica $450 - $473 287%
Medica Uplan $450 287%
Wps $454 289%
Aetna $460 293%
Blue Plus Pmap Pcc Prime $471 300%
Medica Choice $487 310%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 115 Second Street West, Box 157, Graceville, MN 56240
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals