CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Southern Ocean Medical Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $310
Cash Discount Price: $169
vs. Medicare Baseline: 2.46x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Southern Ocean Medical Center is $310. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $169. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.46x the Medicare baseline. Located in 1140 Rt 72 W, Manahawkin, NJ.

Cash / Self-Pay

$169

Average discount available for prompt cash payment at this facility.

Insurance Median

$310

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: $169 (134%)

Insurance Median: $310 (246%)

Cash: $169 (134% of Medicare)

Ins. Median: $310 (246% 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 246% of the Medicare baseline (a markup of 146%). 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
Karna	$64 - $235	51%
Amerihealth	$119 - $121	94%
Clover	$135	107%
Aetna	$138 - $586	109%
Seoul Medical Group	$153	121%
UnitedHealthcare	$158 - $262	125%
Vaccn	$169	134%
Wellcare	$169	134%
Amerigroup	$169	134%
United Community/Americhoice	$178	141%
Oxford	$262 - $405	208%
Cigna	$342 - $598	271%
Horizon	$487 - $684	386%
Bergen Risk	$561	444%
Multiplan - PHCS	$636	504%
Brighton Health Plan	$673	533%
Qualcare	$679	538%

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 $169.
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 Southern Ocean 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.