CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Phelps Memorial Health Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $214
Cash Discount Price: $294
vs. Medicare Baseline: 1.70x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Phelps Memorial Health Center is $214. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $294. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.70x the Medicare baseline. Located in 1215 Tibbals St, Holdrege, NE.

Cash / Self-Pay

$294

Average discount available for prompt cash payment at this facility.

Insurance Median

$214

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: $294 (233%)

Insurance Median: $214 (170%)

Cash: $294 (233% of Medicare)

Ins. Median: $214 (170% 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.

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
UnitedHealthcare	$110 - $374	87%
Aetna	$115 - $356	91%
Blue Cross Blue Shield	$115 - $236	91%
Good Samaritan Mcr Adv - All Plans	$115 - $166	91%
Medica Mcr Adv	$115 - $166	91%
Va Ccn - All Plans	$115 - $166	91%
Wellcare Mcr Adv - All Plans	$115 - $166	91%
Molina Mcaid - All Plans	$118 - $170	93%
Three Rivers - All Plans	$138 - $199	109%
6 Degrees Hlth - All Plans	$214 - $309	170%
Partners Hlth Alliance - All Plans	$214 - $309	170%
Cpi Benefit Group-All Plans	$241 - $347	191%
Providrs Care/Wppa - All Plans	$241 - $347	191%
Provider Network Of American - All Plans	$249 - $359	197%
Medica-All Other Plans	$252 - $363	200%
Chi Health Partners - All Plans	$255 - $367	202%
First Health - All Plans	$255 - $367	202%
Midwest Ntwrk Alliance - All Plans	$255 - $367	202%
Ambetter / Centene	$300 - $432	238%

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 $294.
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 Phelps Memorial Health 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.