CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Ohio Valley Surgical Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $369
  • Cash Discount Price: $246
  • vs. Medicare Baseline: 2.92x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Ohio Valley Surgical Hospital is $369. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $246. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.92x the Medicare baseline. Located in 100 West Main Street, Springfield, OH.
Cash / Self-Pay
$246

Average discount available for prompt cash payment at this facility.

Insurance Median
$369

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: $246 (195%)
Insurance Median: $369 (292%)
Cash: $246 (195% of Medicare)
Ins. Median: $369 (292% 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 292% of the Medicare baseline (a markup of 192%). 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
Blue Cross Blue Shield $83 - $40,293 66%
Medicaid / KanCare $83 - $17,827 66%
Devoted Health $99 - $13,707 78%
Aarp $116 - $11,885 92%
Aarp Supplemental $116 - $11,885 92%
Aetna $116 - $20,896 92%
American Continental Insurance $116 - $11,885 92%
American Continental Life $116 - $11,885 92%
American Republic $116 - $11,885 92%
American Retirement $116 - $11,885 92%
Aultcare Primetime Health Plan $116 - $11,885 92%
Bankers Fidelity $116 - $11,885 92%
Bankers Life And Casualty $116 - $11,885 92%
Central States $116 - $11,885 92%
Champus $116 - $11,885 92%
Cigna $116 - $18,817 92%
Communicare Advantage $116 - $11,885 92%
Everest $116 - $11,885 92%
Gateway Health Plan $116 - $11,885 92%
Humana $116 - $11,919 92%
Medicare (plans) $116 - $12,264 92%
Medigold $116 - $11,885 92%
Mmoh $116 - $11,885 92%
Molina $116 - $11,885 92%
Molina Dual Mcr $116 - $11,885 92%
Molina Marketplace $116 - $11,885 92%
Molina Dual Mcr $116 - $11,885 92%
Molina Mcr $116 - $11,885 92%
Molina Mcr Mcd $116 - $11,885 92%
Molina Mcr+Mcd $116 - $11,885 92%
Patient No Pay $116 - $11,885 92%
Prosperity Supplement $116 - $11,885 92%
UnitedHealthcare $116 - $17,571 92%
Wellcare By Allwell $116 - $11,885 92%
Wraparound Pl Supp $116 - $11,885 92%
The Health Plan $122 - $12,479 97%
Employer Direct $133 - $15,703 105%
Geha $144 - $20,896 114%
Genworth $144 - $20,896 114%
Mail Handlers $144 - $20,896 114%
Meritain $144 - $20,896 114%
Meritain Heatlh $144 - $20,896 114%
Mhbp $144 - $20,896 114%
Ngs Coresource $144 - $20,896 114%
Nippon Life $144 - $20,896 114%
Pacific Source $144 - $20,896 114%
Personify Health $144 - $20,896 114%
Healthgram $149 - $18,817 118%
Nalc $149 - $18,817 118%
Samba $149 - $18,817 118%
Sbma $149 - $18,817 118%
Unified Group $149 - $18,817 118%
Golden Rule $153 - $17,571 121%
Medica $153 - $17,571 121%
Oxford $153 - $17,571 121%
Shl $153 - $17,571 121%
Surest $153 - $17,571 121%
Ushealth $153 - $17,571 121%
Caresource $174 - $17,827 138%
Caresourse $174 - $17,827 138%
Self Pay Imaging $185 - $11,885 147%
Mmo Cin. Hmo $189 - $258 150%
Mmoh (Supermed) $189 - $191 150%
Luminare Health $369 292%
Medben $369 292%
Ohio Health $369 292%
Preferred Health $369 292%
Amerihealth Caritas Of Ohio $3,657 2897%
Buckeye Community Health Plan $4,022 3186%
Molina Mcd $4,084 3235%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 West Main Street, Springfield, OH 45502
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals