CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: University Hospitals Samaritan Medical Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $478
  • Cash Discount Price: $427
  • vs. Medicare Baseline: 3.79x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at University Hospitals Samaritan Medical Center is $478. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $427. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 3.79x the Medicare baseline. Located in 1025 Center St, Ashland, OH.
Cash / Self-Pay
$427

Average discount available for prompt cash payment at this facility.

Insurance Median
$478

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: $427 (338%)
Insurance Median: $478 (379%)
Cash: $427 (338% of Medicare)
Ins. Median: $478 (379% 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 379% of the Medicare baseline (a markup of 279%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $84 - $488 67%
Blue Cross Blue Shield $84 - $514 67%
Cigna $84 - $525 67%
Devoted Health $84 67%
Humana $84 67%
Molina $84 67%
Primetime Health Plan $84 67%
Summacare $84 - $518 67%
The Health Plan $84 - $501 67%
UnitedHealthcare $84 - $525 67%
Wellcare By Allwell $84 67%
Paramount $87 69%
Perennial Advantage Of Ohio $88 70%
Valor Health Plans $88 70%
University Health Employee Plan (Contigo) $129 102%
Amish Aid Community Plan $140 - $262 111%
Amish Church Fund And Workers Aid Plan $140 - $262 111%
Buckeye Plain Ministries $140 - $262 111%
Ambetter / Centene $151 120%
Caresource $151 120%
Medical Mutual Of Ohio $201 - $564 159%
Christian Healthcare Ministries $284 225%
Immergrun $284 225%
Sunrise Plain Communities $284 225%
Medical Mutual Traditional/Health Ohio $398 315%
Beech Street $455 - $512 360%
Ohio Preferred Network $455 - $512 360%
First Health $472 374%
Century Health Network $484 383%
Ohio Health Choice $484 - $512 383%
Private Healthcare System $489 387%
Aultcare $512 406%
Clarity $512 406%
Configurenet $512 406%
Fortified Provider Network $512 406%
Healthsmart $512 406%
Jp Farley $512 406%
Multiplan $512 406%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1025 Center St, Ashland, OH 44805
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals