CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: The Outer Banks Hospital, Inc

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $429
Cash Discount Price: $368
vs. Medicare Baseline: 3.40x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at The Outer Banks Hospital, Inc is $429. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $368. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 3.40x the Medicare baseline. Located in 4800 South Croatan Highway, Nags Head, NC.

Cash / Self-Pay

$368

Average discount available for prompt cash payment at this facility.

Insurance Median

$429

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: $368 (291%)

Insurance Median: $429 (340%)

Cash: $368 (291% of Medicare)

Ins. Median: $429 (340% 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 340% of the Medicare baseline (a markup of 240%). 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	$83	66%
UnitedHealthcare	$85 - $463	67%
Aetna	$87 - $618	69%
Liberty Advantage [1313]	$87	69%
Longevity Health [1411]	$108	86%
Blue Cross Blue Shield	$163 - $484	129%
Wellcare [1320]	$172 - $259	136%
Carolina Complete Health [1317]	$172 - $257	136%
Amerihealth McAid Adv [1316]	$173 - $260	137%
Nc Dept of Public Safety [1095]	$331 - $497	262%
Medcost [1067]	$339 - $532	269%
Cigna	$447 - $750	354%
Multiplan [1031]	$500 - $750	396%

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 $368.
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 Outer Banks Hospital, Inc 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.