CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Fairview Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $228
  • Cash Discount Price: $367
  • vs. Medicare Baseline: 1.81x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Fairview Hospital is $228. 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 1.81x the Medicare baseline. Located in 18101 Lorain Avenue, Cleveland, OH.
Cash / Self-Pay
$367

Average discount available for prompt cash payment at this facility.

Insurance Median
$228

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: $228 (181%)
Cash: $367 (291% of Medicare)
Ins. Median: $228 (181% 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
UnitedHealthcare $42 - $350 33%
Paramount $46 36%
Blue Cross Blue Shield $47 - $362 37%
Buckeye $47 37%
Caresource $47 37%
Molina $47 37%
United $47 - $217 37%
United Bh $47 37%
Amerihealth $49 39%
Aetna $169 - $564 134%
Devoted Health $169 134%
Mmo $169 - $333 134%
Summacare $169 - $214 134%
The Health Plan $169 - $338 134%
Upmc $169 - $338 134%
Valor $169 134%
Zing Health $169 134%
Oscar $170 - $217 135%
Humana $171 - $479 135%
Cigna $174 - $451 138%
Perennial Health $183 145%
Cc Ehp $225 - $228 178%
Aultcare $243 192%
Amish Community Aid Plan $254 - $282 201%
Ohcp $274 217%
Omas $282 223%
Ohio Healthy $305 242%
Healthsmart $310 246%
Php $338 268%
Phphi $338 268%
Gms $395 313%
Medical Benefit Corp $395 313%
Quality Care Partners $395 313%
Consociate Health $423 335%
Frontpath $508 402%
Managed Care Services $508 402%
Multiplan $508 402%
Tertiary Care Network $508 402%
Three Rivers $508 402%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 18101 Lorain Avenue, Cleveland, OH 44111
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals