CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Salem Memorial District Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $357
  • Cash Discount Price: $329
  • vs. Medicare Baseline: 2.27x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Salem Memorial District Hospital is $357. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $329. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 2.27x the Medicare baseline. Located in Po Box 774, Salem, MO.
Cash / Self-Pay
$329

Average discount available for prompt cash payment at this facility.

Insurance Median
$357

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: $329 (210%)
Insurance Median: $357 (227%)
Cash: $329 (210% of Medicare)
Ins. Median: $357 (227% 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 227% of the Medicare baseline (a markup of 127%). 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
Aetna $125 - $454 80%
Ambetter / Centene $125 - $171 80%
Blue Cross Blue Shield $125 - $479 80%
Humana $125 - $428 80%
Tricare $125 - $171 80%
Triwest $125 - $171 80%
UnitedHealthcare $125 - $171 80%
Veteran'S Affairs $125 - $171 80%
Healthlink $239 - $328 152%
First Health $294 - $403 187%
Mercy - C.B. Management Company/Joplin Supply Company $294 - $403 187%
Mercy - City Of Springfield $294 - $403 187%
Mercy - Clayco $294 - $403 187%
Mercy - Commerce Bank $294 - $403 187%
Mercy - Diversified Plastics $294 - $403 187%
Mercy - Employers Benefit Alliance $294 - $403 187%
Mercy - Evolutions $294 - $403 187%
Mercy - Fabick Cat $294 - $403 187%
Mercy - Firsthealth Network $294 - $403 187%
Mercy - Health Management Network $294 - $403 187%
Mercy - Health Systems Inc $294 - $403 187%
Mercy - Liberty Utilities/Empire District Electric $294 - $403 187%
Mercy - Life Church $294 - $403 187%
Mercy - Missouri State University $294 - $403 187%
Mercy - Prime Health Services $294 - $403 187%
Mercy - Quiktrip Corporation $294 - $403 187%
Mercy - Shinesolar $294 - $403 187%
Mercy - Springfield Public Schools $294 - $403 187%
Mercy - Springfield Remanufacturing $294 - $403 187%
Mercy - Sumnerone $294 - $403 187%
Mercy - Trailiner $294 - $403 187%
Mercy - Walmart Mercy Accountable Care Plan $294 - $403 187%
Mercy-American Healthcare Alliance $294 - $403 187%
Phcs $294 - $428 187%
Cigna $312 - $428 199%
Mercy - Compresults $331 - $454 211%
Mercy - Corvel Corporation $331 - $454 211%
Mercy - Novasys $331 - $454 211%
Mercy - Scurlock Industries $331 - $454 211%
Mercy - Usa Managed Care Organization $331 - $454 211%
Right Choice-Alliance $349 - $479 222%
Right Choice-Regular $356 - $489 227%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: Po Box 774, Salem, MO 65560
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals