CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Fairfield Medical Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $83
Cash Discount Price: $170
vs. Medicare Baseline: 0.66x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Fairfield Medical Center is $83. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $170. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.66x the Medicare baseline. Located in 401 North Ewing Street, Lancaster, OH.

Cash / Self-Pay

$170

Average discount available for prompt cash payment at this facility.

Insurance Median

$83

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: $170 (135%)

Insurance Median: $83 (66%)

Cash: $170 (135% of Medicare)

Ins. Median: $83 (66% 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
Caresource	$24 - $108	19%
Medicaid / KanCare	$24 - $48	19%
Molina	$24 - $137	19%
UnitedHealthcare	$24 - $308	19%
Amerihealth Caritas Ohio	$25 - $50	20%
Blue Cross Blue Shield	$25 - $26,250	20%
Buckeye Community Health	$25 - $129	20%
Humana	$25 - $358	20%
Aetna	$41 - $247	32%
Medical Mutual	$41 - $253	32%
Medicare (plans)	$41 - $82	32%
Medigold	$42 - $83	33%
The Health Plan	$42 - $261	33%
Va Ccn	$42 - $83	33%
Valor Health Plan	$42 - $83	33%
Oscar	$54 - $154	43%
Bwc	$58 - $116	46%
Allied Benefit Systems	$262	208%
Meritain Health	$262	208%
Quality Care Partners/Ohio Ppo Connect	$271	215%
The Ohio State Health Plan	$290	230%
Cigna	$311	246%
Ohio Healthy	$354	280%
Multiplan	$358	284%
Miscellaneous Plans	$377	299%

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 $170.
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 Fairfield 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.