CMS Price Transparency Data
Screening mammogram (both breasts)
Facility: Mercy Hospital Joplin
Billing Code: 77067 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 77067
- Insurance Median: $165
- Cash Discount Price: $206
- vs. Medicare Baseline: 1.31x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Mercy Hospital Joplin is $165. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $206. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.31x the Medicare baseline. Located in 100 Mercy Way, Joplin, MO.
Cash / Self-Pay
$206
Average discount available for prompt cash payment at this facility.
Insurance Median
$165
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: $206 (163%)
Insurance Median: $165 (131%)
Cash: $206 (163% of Medicare)
Ins. Median: $165 (131% 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 |
|---|---|---|
| Blue Cross Blue Shield | $72 - $278 | 57% |
| Medicaid / KanCare | $72 - $196 | 57% |
| Humana | $73 - $114 | 58% |
| Aetna | $76 - $236 | 60% |
| Champva [20065] | $76 | 60% |
| Cherokee Nation Health Serv Contracted [320066] | $76 | 60% |
| Cigna | $76 - $419 | 60% |
| Cross Timbers Hospice [20098] | $76 | 60% |
| Dept Of Veteran Affairs Contracted [320106] | $76 | 60% |
| Elara Caring Aspire Hospice [20433] | $76 | 60% |
| Globalhealth Contracted [320145] | $76 | 60% |
| Halo Hcr Inc Hospice Contracted [320432] | $76 | 60% |
| Halo Hcr Inc Hospice [20432] | $76 | 60% |
| Indian Health Service Contracted [320198] | $76 - $248 | 60% |
| Kindful Hospice Contracted [320434] | $76 | 60% |
| Kindful Hospice [20434] | $76 | 60% |
| Medicare (plans) | $76 - $86 | 60% |
| Mercy Hospice Okc [20252] | $76 | 60% |
| Mercy Mgd Behavioral Health Contracted [320259] | $76 | 60% |
| Pace Of The Ozarks Contracted [320518] | $76 | 60% |
| Provider Partners Health Plans Contracted [320450] | $76 | 60% |
| Qual Choice Contracted [320325] | $76 | 60% |
| Tricare | $76 | 60% |
| UnitedHealthcare | $76 - $217 | 60% |
| Point C Contracted [320238] | $89 - $305 | 70% |
| Medica Contracted [320239] | $92 - $139 | 73% |
| Healthscope Contracted [320182] | $95 | 75% |
| Benefit Management Contracted [320052] | $109 - $164 | 86% |
| Health Systems Inc Contracted [320174] | $109 - $164 | 86% |
| Insurance System Inc Contracted [320465] | $109 - $164 | 86% |
| Administrative Payor Contracted [320005] | $114 - $171 | 90% |
| Centivo Contracted [320505] | $127 | 101% |
| Mercy Benefit Admin Contracted [320251] | $127 - $229 | 101% |
| Aither Health Contracted [320449] | $145 - $217 | 115% |
| Auxiant Contracted [320462] | $145 - $248 | 115% |
| Ebms Contracted [320493] | $145 - $217 | 115% |
| Edison Health Solutions Contracted [320502] | $145 - $217 | 115% |
| Healthlink Contracted [320179] | $145 - $305 | 115% |
| Imagine 360 Contracted [320494] | $145 - $217 | 115% |
| Reflect Health Contracted [320492] | $145 - $217 | 115% |
| Yuzu Health Contracted [320521] | $145 - $217 | 115% |
| 90 Degree Benefits Contracted [320436] | $152 - $229 | 120% |
| Show-Me Health Administrators Contracted [320483] | $152 - $229 | 120% |
| Providrs Care Network Contracted [320484] | $154 | 122% |
| Preferred Health Plan Contracted [320522] | $165 - $248 | 131% |
| United Medical Resources Contracted [320454] | $168 - $251 | 133% |
| First Health Contracted [320128] | $173 - $259 | 137% |
| American Healthcare Alliance Contracted [320020] | $178 - $267 | 141% |
| Ambetter / Centene | $196 | 155% |
| Home State Health Plan Contracted [320187] | $196 | 155% |
| Multiplan Contracted [320270] | $196 - $293 | 155% |
| Novasys Contracted [320285] | $196 | 155% |
| Private Health Care Systems Contracted [320320] | $196 - $293 | 155% |
| Usable Contracted [320409] | $196 - $293 | 155% |
| Health Choice Contracted [320166] | $203 | 161% |
| Point C [20238] | $203 - $305 | 161% |
| Workers Comp [20426] | $203 - $381 | 161% |
| Usa Managed Care Org Contracted [320429] | $224 - $335 | 177% |
| Ppo Plus Contracted [320310] | $229 - $343 | 181% |