CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Merit Health Madison

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $130
Cash Discount Price: $191
vs. Medicare Baseline: 0.83x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Merit Health Madison is $130. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $191. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 0.83x the Medicare baseline. Located in 161 River Oaks Drive, Canton, MS.

Cash / Self-Pay

$191

Average discount available for prompt cash payment at this facility.

Insurance Median

$130

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: $191 (122%)

Insurance Median: $130 (83%)

Cash: $191 (122% of Medicare)

Ins. Median: $130 (83% 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.

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
Ms-Can-Magnolia	$86	55%
Ms-Can-Molina	$86	55%
Ms-Can-Truecare	$87	55%
Cigna	$92	59%
Medicare (plans)	$95	61%
Wellcare	$98	62%
Humana	$99	63%
Devoted_Health	$100	64%
Advhealth	$110	70%
Blue Cross Blue Shield	$130	83%
Mpcn	$181	115%
Molina-Chip	$183	117%
Magnolia-Chip	$187	119%
Truecare-Chip	$187	119%
Firstchoice	$190	121%
Molina_Exchange	$204	130%
Ambetter / Centene	$240	153%
United	$241	154%
United_Exchange	$241	154%

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 $191.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77066.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Merit Health Madison is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77066.
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.