CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Union Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $141
  • Cash Discount Price: $367
  • vs. Medicare Baseline: 1.12x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Union Hospital is $141. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $367. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.12x the Medicare baseline. Located in 659 Boulevard, Dover, OH.
Cash / Self-Pay
$367

Average discount available for prompt cash payment at this facility.

Insurance Median
$141

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: $367 (291%)
Insurance Median: $141 (112%)
Cash: $367 (291% of Medicare)
Ins. Median: $141 (112% 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
Summacare $22 - $587 17%
Aetna $34 - $838 27%
Blue Cross Blue Shield $34 - $300 27%
Cigna $34 - $254 27%
Humana $34 - $169 27%
The Health Plan $34 - $485 27%
United $34 - $279 27%
Valor $34 - $169 27%
Mmo $35 - $587 28%
Aultcare $36 - $254 29%
Communicare $36 - $178 29%
Perennial Health $37 - $183 29%
Pphp $37 - $127 29%
Cc Ehp $38 - $421 30%
Zing Health $38 - $169 30%
Buckeye $45 - $61 36%
Caresource $45 - $64 36%
Molina $48 - $61 38%
Amerihealth $50 - $67 40%
Oscar $73 - $224 58%
Ohcp $107 - $326 85%
Omas $137 - $419 109%
Healthsmart $151 - $461 120%
Phphi $164 - $503 130%
Upmc $164 - $503 130%
Devoted Health $169 134%
UnitedHealthcare $171 135%
Gms $192 - $587 152%
Consociate Health $206 - $628 163%
Multiplan $247 - $754 196%
Amish Community Aid Plan $254 - $282 201%
Ohio Healthy $305 242%
Php $338 268%
Medical Benefit Corp $395 313%
Frontpath $508 402%
Managed Care Services $508 402%
Tertiary Care Network $508 402%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 659 Boulevard, Dover, OH 44622
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals