CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Carolina East Medical Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $261
Cash Discount Price: $215
vs. Medicare Baseline: 2.07x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Carolina East Medical Center is $261. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $215. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.07x the Medicare baseline. Located in 2000 Neuse Blvd, New Bern, NC.

Cash / Self-Pay

$215

Average discount available for prompt cash payment at this facility.

Insurance Median

$261

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: $215 (170%)

Insurance Median: $261 (207%)

Cash: $215 (170% of Medicare)

Ins. Median: $261 (207% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 207% of the Medicare baseline (a markup of 107%). 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
Humana	$34 - $119	27%
Inclusive Health (Nchirp)-All Plans	$34 - $119	27%
Tricare	$34 - $477	27%
Pamlico Co Jail-All Plans	$78 - $127	62%
UnitedHealthcare	$102 - $339	81%
Craven Co. Jail Systems - All Plans	$121 - $203	96%
Medcost Ppo Employees And Retirees	$192 - $313	152%
Medcost Ppo Ultra (Employees)	$192 - $298	152%
Blue Cross Blue Shield	$204 - $327	162%
Medcost Ppo City Employees	$213 - $347	169%
Medcost Ppo County Employee	$221 - $361	175%
Benefit Mgmt, Svcs-All Plans	$248 - $405	196%
Medcost Benefit Svc-All Other Plans	$258 - $422	204%
Aetna	$259 - $423	205%
Acs Consult Svc Inc-All Plans	$264 - $431	209%
Medcost Ppo Standard	$264 - $431	209%
Cigna	$266 - $434	211%

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 $215.
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 Carolina East Medical Center 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.