CMS Price Transparency Data
Screening mammogram (both breasts)
Facility: Mercy Hospital Carthage
Billing Code: 77067 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 77067
- Insurance Median: $104
- Cash Discount Price: $99
- vs. Medicare Baseline: 0.82x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Mercy Hospital Carthage is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $99. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.82x the Medicare baseline. Located in 3125 Dr Russell Smith Way, Carthage, MO.
Cash / Self-Pay
$99
Average discount available for prompt cash payment at this facility.
Insurance Median
$104
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: $99 (78%)
Insurance Median: $104 (82%)
Cash: $99 (78% of Medicare)
Ins. Median: $104 (82% 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 |
|---|---|---|
| Aetna | $34 - $162 | 27% |
| Blue Cross Blue Shield | $34 - $319 | 27% |
| Cherokee Nation Health Serv Contracted [320066] | $34 - $50 | 27% |
| Cigna | $34 - $164 | 27% |
| Cross Timbers Hospice [20098] | $34 - $50 | 27% |
| Dept Of Veteran Affairs Contracted [320106] | $34 - $50 | 27% |
| Elara Caring Aspire Hospice [20433] | $34 - $50 | 27% |
| Globalhealth Contracted [320145] | $34 - $50 | 27% |
| Halo Hcr Inc Hospice Contracted [320432] | $34 - $50 | 27% |
| Halo Hcr Inc Hospice [20432] | $34 - $50 | 27% |
| Humana | $34 - $77 | 27% |
| Indian Health Service Contracted [320198] | $34 - $50 | 27% |
| Kindful Hospice Contracted [320434] | $34 - $50 | 27% |
| Kindful Hospice [20434] | $34 - $50 | 27% |
| Medical Associates Health Contracted [320444] | $34 - $50 | 27% |
| Medicare (plans) | $34 - $79 | 27% |
| Mercy Hospice Okc [20252] | $34 - $50 | 27% |
| Mercy Mgd Behavioral Health Contracted [320259] | $34 - $50 | 27% |
| Pace Of The Ozarks Contracted [320518] | $34 - $50 | 27% |
| Provider Partners Health Plans Contracted [320450] | $34 - $50 | 27% |
| Qual Choice Contracted [320325] | $34 - $50 | 27% |
| Tricare | $34 - $50 | 27% |
| UnitedHealthcare | $34 - $166 | 27% |
| Point C Contracted [320238] | $43 - $164 | 34% |
| Health Systems Inc Contracted [320174] | $52 - $78 | 41% |
| Insurance System Inc Contracted [320465] | $52 - $78 | 41% |
| Administrative Payor Contracted [320005] | $55 - $82 | 44% |
| Centivo Contracted [320505] | $56 - $84 | 44% |
| Healthscope Contracted [320182] | $64 - $95 | 51% |
| Ambetter / Centene | $67 - $100 | 53% |
| Home State Health Plan Contracted [320187] | $67 - $100 | 53% |
| Medicaid / KanCare | $67 - $165 | 53% |
| Novasys Contracted [320285] | $67 - $100 | 53% |
| Benefit Management Contracted [320052] | $73 - $158 | 58% |
| Auxiant Contracted [320462] | $79 - $155 | 63% |
| Healthlink Contracted [320179] | $79 - $169 | 63% |
| Preferred Health Plan Contracted [320522] | $79 - $118 | 63% |
| Workers Comp [20426] | $98 - $182 | 78% |
| United Medical Resources Contracted [320454] | $101 - $164 | 80% |
| 90 Degree Benefits Contracted [320436] | $104 - $155 | 82% |
| Aither Health Contracted [320449] | $104 - $155 | 82% |
| Ebms Contracted [320493] | $104 - $155 | 82% |
| Edison Health Solutions Contracted [320502] | $104 - $155 | 82% |
| Imagine 360 Contracted [320494] | $104 - $155 | 82% |
| Mercy Benefit Admin Contracted [320251] | $104 - $164 | 82% |
| Reflect Health Contracted [320492] | $104 - $155 | 82% |
| Show-Me Health Administrators Contracted [320483] | $104 - $155 | 82% |
| Yuzu Health Contracted [320521] | $104 - $155 | 82% |
| Evolutions Health Care Contracted [320124] | $106 - $158 | 84% |
| First Health Contracted [320128] | $106 - $158 | 84% |
| Medica Contracted [320239] | $106 - $158 | 84% |
| Multiplan Contracted [320270] | $106 - $158 | 84% |
| Private Health Care Systems Contracted [320320] | $106 - $158 | 84% |
| American Healthcare Alliance Contracted [320020] | $110 - $164 | 87% |
| Ppo Plus Contracted [320310] | $110 - $164 | 87% |
| Usa Managed Care Org Contracted [320429] | $110 - $164 | 87% |