CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Lexington Memorial Hospital Inc

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $683
Cash Discount Price: $767
vs. Medicare Baseline: 4.35x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Lexington Memorial Hospital Inc is $683. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $767. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 4.35x the Medicare baseline. Located in 250 Hospital Drive Po Box 1817, Lexington, NC.

Cash / Self-Pay

$767

Average discount available for prompt cash payment at this facility.

Insurance Median

$683

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: $767 (489%)

Insurance Median: $683 (435%)

Cash: $767 (489% of Medicare)

Ins. Median: $683 (435% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 435% of the Medicare baseline (a markup of 335%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Amerihealth	$289 - $421	184%
Carolina Complete	$289	184%
Healthy Blue	$289	184%
Partners	$289	184%
UnitedHealthcare	$292 - $687	186%
Vaya	$292	186%
Wellcare	$292	186%
Alliance	$295	188%
Trillium	$298	190%
Medcost	$336 - $1,026	214%
Aetna	$435 - $1,416	277%
Ambetter / Centene	$440	280%
Blue Cross Blue Shield	$440 - $707	280%
Oscar	$491 - $675	313%
Cigna	$667 - $679	425%
Directnet	$906	577%
Healthgram Lexington Home Brands	$1,104	703%
Healthgram	$1,226	781%
Private Healthcare Systems	$1,257	801%
Beechstreet	$1,349	859%
Humana	$1,349	859%
Multiplan	$1,380	879%
National Provider Network	$1,380	879%

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 $767.
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 Lexington Memorial Hospital Inc 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.