CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Lexington Memorial Hospital Inc

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $165
  • Cash Discount Price: $187
  • vs. Medicare Baseline: 1.31x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Lexington Memorial Hospital Inc is $165. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $187. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.31x the Medicare baseline. Located in 250 Hospital Drive Po Box 1817, Lexington, NC.
Cash / Self-Pay
$187

Average discount available for prompt cash payment at this facility.

Insurance Median
$165

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: $187 (148%)
Insurance Median: $165 (131%)
Cash: $187 (148% of Medicare)
Ins. Median: $165 (131% 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.

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 $70 - $102 55%
Carolina Complete $70 55%
Healthy Blue $70 55%
Partners $70 55%
UnitedHealthcare $71 - $167 56%
Vaya $71 56%
Wellcare $71 56%
Alliance $72 57%
Trillium $72 57%
Blue Cross Blue Shield $79 - $126 63%
Medcost $82 - $250 65%
Aetna $106 - $345 84%
Ambetter / Centene $107 85%
Oscar $119 - $164 94%
Cigna $162 - $165 128%
Directnet $220 174%
Healthgram Lexington Home Brands $269 213%
Healthgram $298 236%
Private Healthcare Systems $306 242%
Beechstreet $328 260%
Humana $328 260%
Multiplan $336 266%
National Provider Network $336 266%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 250 Hospital Drive Po Box 1817, Lexington, NC 27293
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals