CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: South Sunflower County Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $112
Cash Discount Price: $73
vs. Medicare Baseline: 0.89x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at South Sunflower County Hospital is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $73. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.89x the Medicare baseline. Located in 121 East Baker Street, Indianola, MS.

Cash / Self-Pay

$73

Average discount available for prompt cash payment at this facility.

Insurance Median

$112

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: $73 (58%)

Insurance Median: $112 (89%)

Cash: $73 (58% of Medicare)

Ins. Median: $112 (89% 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
Primewell Mcr Adv	$33 - $112	26%
UnitedHealthcare	$40	32%
Advanced Health Systems - All Plans	$49 - $474	39%
Multiplan - All Plans	$51 - $185	40%
Primewell Comm - All Other Plans	$54 - $280	43%
Medicaid / KanCare	$99 - $110	78%
Trucare - All Plans	$100 - $111	79%
Aetna	$117 - $163	93%
Blue Cross Blue Shield	$133 - $185	105%
Physician Care Network - All Plans	$274 - $380	217%

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 $73.
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 South Sunflower County Hospital 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.