CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Essentia Health Fosston

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $229
Cash Discount Price: $338
vs. Medicare Baseline: 1.81x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Essentia Health Fosston is $229. 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 1.81x the Medicare baseline. Located in 900 Hilligoss Boulevard Se, Fosston, MN.

Cash / Self-Pay

$338

Average discount available for prompt cash payment at this facility.

Insurance Median

$229

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: $229 (181%)

Cash: $338 (268% of Medicare)

Ins. Median: $229 (181% 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.

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
Itasca Med Care	$92	73%
Primewest	$94	74%
Healthpartners Care Pmap	$178	141%
Medica Access	$182	144%
Sanford Health Plan	$196 - $206	155%
Advocare/Security Health	$228	181%
Blue Cross Blue Shield	$228 - $398	181%
Freedom Blue Ppo	$228	181%
Healthpartners Care Msho / Mcr Adv	$228	181%
Imcare Msho Pcc Prime	$228	181%
Imcare Msho Ref Req	$228	181%
Medica Advantage Solutions	$228	181%
Medica Msho/Dual Solutions	$228	181%
Medica Prime Solution Group	$228	181%
Medicare (plans)	$228	181%
Nd Va Administration	$228	181%
Platinum Blue/Vantage Blue	$228	181%
Primewest Msho	$228	181%
Secure Blue Msho	$228	181%
Ubh Cost Plan	$228	181%
Ubh Msho	$228	181%
Ucare Msho	$228	181%
UnitedHealthcare	$228 - $414	181%
Healthpartners	$278 - $304	220%
Ucare	$301	238%
Cigna	$304	241%
Healthpartners Pcc Prime	$304	241%
Wea	$329 - $352	261%
America'S Ppo	$354	280%
Medica	$380 - $400	301%
Medica Uplan	$380	301%
Wps	$384	304%
Aetna	$388	307%
Blue Plus Pmap Pcc Prime	$398	315%
Medica Choice	$412	326%

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 $338.
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 Essentia Health Fosston 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.