CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: The McDowell Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $96
Cash Discount Price: $474
vs. Medicare Baseline: 0.76x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at The McDowell Hospital is $96. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $474. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.76x the Medicare baseline. Located in 430 Rankin Drive P O Box 730, Marion, NC.

Cash / Self-Pay

$474

Average discount available for prompt cash payment at this facility.

Insurance Median

$96

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: $474 (375%)

Insurance Median: $96 (76%)

Cash: $474 (375% of Medicare)

Ins. Median: $96 (76% 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
Blue Cross Blue Shield	$63	50%
United	$64 - $244	51%
Wellcare	$65 - $88	51%
Amerihealth	$66	52%
Partners Health Management	$66	52%
Vaya Health	$66	52%
Alignment Health	$85	67%
Devoted Health	$85	67%
Aetna	$87 - $343	69%
Humana	$88	70%
Provider Partners Health Plan	$90	71%
Cigna	$92 - $254	73%
Troy Healthcare	$92	73%
Healthteam Advantage	$93	74%
Apex Health	$95	75%
Amerihealth Caritas	$97	77%
Longevity Health Plan	$102	81%
Caresource	$208	165%
Medcost	$232 - $403	184%
Magellan	$284	225%
Magellan Behavioral Health	$284	225%
Multiplan	$379	300%
Avalon Administrative Services	$403	319%
Prime Health	$417 - $426	330%

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 $474.
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 The McDowell 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.