CMS Price Transparency Data
Diagnostic mammogram (both breasts)
Facility: Mercy Hospital Carthage
Billing Code: 77066 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 77066
- Insurance Median: $165
- Cash Discount Price: $165
- vs. Medicare Baseline: 1.05x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Mercy Hospital Carthage is $165. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $165. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.05x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.
Cash / Self-Pay
$165
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
$156.98
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Medicare Reference Baseline: $156.98 (100%)
Cash / Self-Pay: $165 (105%)
Insurance Median: $165 (105%)
Cash: $165 (105% of Medicare)
Ins. Median: $165 (105% 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.
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 | $60 - $384 | 38% |
| Medicaid / KanCare | $60 - $203 | 38% |
| Aetna | $70 - $226 | 45% |
| Cherokee Nation Health Serv Contracted [320066] | $70 | 45% |
| Cigna | $70 - $229 | 45% |
| Cross Timbers Hospice [20098] | $70 | 45% |
| Dept Of Veteran Affairs Contracted [320106] | $70 | 45% |
| Elara Caring Aspire Hospice [20433] | $70 | 45% |
| Globalhealth Contracted [320145] | $70 | 45% |
| Halo Hcr Inc Hospice Contracted [320432] | $70 | 45% |
| Halo Hcr Inc Hospice [20432] | $70 | 45% |
| Humana | $70 - $93 | 45% |
| Indian Health Service Contracted [320198] | $70 | 45% |
| Kindful Hospice Contracted [320434] | $70 | 45% |
| Kindful Hospice [20434] | $70 | 45% |
| Medical Associates Health Contracted [320444] | $70 | 45% |
| Medicare (plans) | $70 - $96 | 45% |
| Mercy Hospice Okc [20252] | $70 | 45% |
| Mercy Mgd Behavioral Health Contracted [320259] | $70 | 45% |
| Pace Of The Ozarks Contracted [320518] | $70 | 45% |
| Provider Partners Health Plans Contracted [320450] | $70 | 45% |
| Qual Choice Contracted [320325] | $70 | 45% |
| Tricare | $70 | 45% |
| UnitedHealthcare | $70 - $221 | 45% |
| Point C Contracted [320238] | $89 - $229 | 57% |
| Health Systems Inc Contracted [320174] | $109 | 69% |
| Insurance System Inc Contracted [320465] | $109 | 69% |
| Administrative Payor Contracted [320005] | $114 | 73% |
| Centivo Contracted [320505] | $117 | 75% |
| United Medical Resources Contracted [320454] | $121 - $229 | 77% |
| Healthscope Contracted [320182] | $132 | 84% |
| Ambetter / Centene | $139 | 89% |
| Home State Health Plan Contracted [320187] | $139 | 89% |
| Novasys Contracted [320285] | $139 | 89% |
| Benefit Management Contracted [320052] | $152 - $221 | 97% |
| Auxiant Contracted [320462] | $165 - $216 | 105% |
| Healthlink Contracted [320179] | $165 - $236 | 105% |
| Preferred Health Plan Contracted [320522] | $165 | 105% |
| Workers Comp [20426] | $203 - $254 | 129% |
| 90 Degree Benefits Contracted [320436] | $216 | 138% |
| Aither Health Contracted [320449] | $216 | 138% |
| Ebms Contracted [320493] | $216 | 138% |
| Edison Health Solutions Contracted [320502] | $216 | 138% |
| Imagine 360 Contracted [320494] | $216 | 138% |
| Mercy Benefit Admin Contracted [320251] | $216 - $229 | 138% |
| Reflect Health Contracted [320492] | $216 | 138% |
| Show-Me Health Administrators Contracted [320483] | $216 | 138% |
| Yuzu Health Contracted [320521] | $216 | 138% |
| Medica Contracted [320239] | $220 | 140% |
| Evolutions Health Care Contracted [320124] | $221 | 141% |
| First Health Contracted [320128] | $221 | 141% |
| Multiplan Contracted [320270] | $221 | 141% |
| Private Health Care Systems Contracted [320320] | $221 | 141% |
| American Healthcare Alliance Contracted [320020] | $229 | 146% |
| Ppo Plus Contracted [320310] | $229 | 146% |
| Usa Managed Care Org Contracted [320429] | $229 | 146% |