CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Merit Health Madison

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $107
Cash Discount Price: $172
vs. Medicare Baseline: 0.85x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Merit Health Madison is $107. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $172. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.85x the Medicare baseline. Located in 161 River Oaks Drive, Canton, MS.

Cash / Self-Pay

$172

Average discount available for prompt cash payment at this facility.

Insurance Median

$107

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: $172 (136%)

Insurance Median: $107 (85%)

Cash: $172 (136% of Medicare)

Ins. Median: $107 (85% 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.

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	$71	56%
Ms-Can-Molina	$71	56%
Ms-Can-Truecare	$72	57%
Cigna	$76	60%
Medicare (plans)	$78	62%
Wellcare	$81	64%
Devoted_Health	$82	65%
Humana	$82	65%
Advhealth	$91	72%
Blue Cross Blue Shield	$107	85%
Mpcn	$149	118%
Molina-Chip	$151	120%
Magnolia-Chip	$155	123%
Truecare-Chip	$155	123%
Firstchoice	$157	124%
Molina_Exchange	$169	134%
Ambetter / Centene	$198	157%
United	$200	158%
United_Exchange	$200	158%

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 $172.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77067.

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 77067.
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.