CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Atrium Health Cleveland

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $279
Cash Discount Price: $443
vs. Medicare Baseline: 1.78x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Atrium Health Cleveland is $279. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $443. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.78x the Medicare baseline. Located in 201 E Grover St, Shelby, NC.

Cash / Self-Pay

$443

Average discount available for prompt cash payment at this facility.

Insurance Median

$279

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: $443 (282%)

Insurance Median: $279 (178%)

Cash: $443 (282% of Medicare)

Ins. Median: $279 (178% 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
Trillium	$35 - $131	22%
Alliance	$36 - $148	23%
Amerihealth Caritas	$36 - $125	23%
Carolina Complete Health	$36 - $127	23%
Healthy Blue	$36 - $127	23%
Partners	$36 - $124	23%
UnitedHealthcare	$36 - $473	23%
Vaya	$36 - $129	23%
Wellcare	$36 - $127	23%
Cigna	$44 - $708	28%
Humana	$45 - $147	29%
Aetna	$46 - $682	29%
Blue Cross Blue Shield	$275 - $363	175%
Ambetter / Centene	$283 - $321	180%
Employers Health Network	$391	249%
Physician Reach Out	$443	282%
Medcost	$494 - $587	315%
Magellan	$531	338%
Gmmi	$575	366%
Quik Trip	$575	366%
Carolina Behavioral Health	$637 - $708	406%
Healthgram	$708	451%
Choicecare	$726	462%
First Health	$752	479%
Lifesynch Community Choice Care	$752	479%
Private Health Care Systems	$797	508%
Beechstreet	$814	519%
Multiplan	$841	536%

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 $443.
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 Atrium Health Cleveland 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.