CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Blue Ridge Regional Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $87
  • Cash Discount Price: $474
  • vs. Medicare Baseline: 0.69x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Blue Ridge Regional Hospital is $87. 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 0.69x the Medicare baseline. Located in 125 Hospital Drive, Spruce Pine, NC.
Cash / Self-Pay
$474

Average discount available for prompt cash payment at this facility.

Insurance Median
$87

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: $87 (69%)
Cash: $474 (375% of Medicare)
Ins. Median: $87 (69% 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
Blue Cross Blue Shield $76 - $80 60%
United $81 - $224 64%
Alignment Health $82 - $84 65%
Apex Health $82 - $95 65%
Devoted Health $82 - $84 65%
Wellcare $82 - $85 65%
Amerihealth $83 66%
Nhc Advantage $83 - $85 66%
Partners Health Management $83 66%
Vaya Health $83 66%
Aetna $84 - $343 67%
Cigna $85 - $194 67%
Humana $85 67%
Amerihealth Caritas $86 - $175 68%
Healthteam Advantage $86 - $90 68%
Provider Partners Health Plan $86 - $87 68%
Troy Healthcare $86 - $89 68%
Longevity Health Plan $88 - $98 70%
Caresource $208 165%
Medcost $221 - $245 175%
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

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 125 Hospital Drive, Spruce Pine, NC 28777
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals