CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Essentia Health Moose Lake

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $215
  • Cash Discount Price: $338
  • vs. Medicare Baseline: 1.70x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Essentia Health Moose Lake is $215. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $338. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.70x the Medicare baseline. Located in 4572 County Road 61, Moose Lake, MN.
Cash / Self-Pay
$338

Average discount available for prompt cash payment at this facility.

Insurance Median
$215

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: $338 (268%)
Insurance Median: $215 (170%)
Cash: $338 (268% of Medicare)
Ins. Median: $215 (170% 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.

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 $92 73%
Primewest $94 74%
Medica Access $182 144%
Healthpartners Care Pmap $184 146%
Sanford Healthplan $196 - $206 155%
Blue Cross Blue Shield $206 - $252 163%
Advocare/Security Health $215 170%
Freedom Blue Ppo $215 170%
Healthpartners Care Msho / Mcr Adv $215 170%
Imcare Msho Pcc Prime $215 170%
Imcare Msho Ref Req $215 170%
Medica Advantage Solutions $215 170%
Medica Msho/Dual Solutions $215 170%
Medica Prime Solution Group $215 170%
Medicare (plans) $215 170%
Nd Va Administration $215 170%
Platinum Blue/Vantage Blue $215 170%
Primewest Msho $215 170%
Secure Blue Msho $215 170%
Ubh Cost Plan $215 170%
Ubh Msho $215 170%
Ucare Msho $215 170%
UnitedHealthcare $215 - $414 170%
Blue Plus Pmap Pcc Prime $252 200%
Ucare $301 238%
Healthpartners $320 - $356 253%
Medica $327 - $363 259%
Medica Uplan $327 259%
Wea $329 - $352 261%
America'S Ppo $354 280%
Cigna $356 282%
Healthpartners Pcc Prime $356 282%
Medica Choice $374 296%
Wps $384 304%
Aetna $388 307%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 4572 County Road 61, Moose Lake, MN 55767
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals