CMS Price Transparency Data
Screening mammogram (both breasts)
Facility: Mount Carmel Dublin
Billing Code: 77067 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 77067
- Insurance Median: $57
- Cash Discount Price: $79
- vs. Medicare Baseline: 0.45x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Mount Carmel Dublin is $57. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $79. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.45x the Medicare baseline. Located in 4105 Emerald Pkwy, Dublin, OH.
Cash / Self-Pay
$79
Average discount available for prompt cash payment at this facility.
Insurance Median
$57
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: $79 (63%)
Insurance Median: $57 (45%)
Cash: $79 (63% of Medicare)
Ins. Median: $57 (45% 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
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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 | $55 - $164 | 44% |
| Geha | $55 - $207 | 44% |
| Gravie Admin Services | $55 | 44% |
| Healthez | $55 | 44% |
| Meritain | $55 | 44% |
| Webtpa | $55 | 44% |
| Access Health | $57 | 45% |
| Acclaim | $57 | 45% |
| Administrative Concepts | $57 | 45% |
| Allegeant | $57 | 45% |
| Allied Benefit Systems | $57 | 45% |
| American Family | $57 | 45% |
| American Healthcare Alliance | $57 | 45% |
| American National | $57 | 45% |
| American Republic | $57 | 45% |
| Amerihealth | $57 | 45% |
| Aultcare | $57 | 45% |
| Automated Benefit Services | $57 | 45% |
| Auxiant | $57 | 45% |
| Benefit Administrative Systems,Llc | $57 | 45% |
| Boon Chapman | $57 | 45% |
| Cam Administrative Services | $57 | 45% |
| Christian Brother Services | $57 | 45% |
| Christian Brothers Holy Cross | $57 | 45% |
| Claimchoice Adminstrators | $57 | 45% |
| Comprehensive Benefits | $57 | 45% |
| Continental Life Insurance | $57 | 45% |
| Coventry | $57 | 45% |
| Custom Benefit Administrators | $57 | 45% |
| Cypress Benefit Administrators | $57 | 45% |
| Employee Benefit Concepts | $57 | 45% |
| Employee Benefit Management | $57 | 45% |
| Forest County Potawatomi | $57 | 45% |
| Freedom Life Insurance Company | $57 | 45% |
| Group Administrators | $57 | 45% |
| Group Marketing Services | $57 | 45% |
| Group Pension Administrators | $57 | 45% |
| Guardian | $57 | 45% |
| Health America | $57 | 45% |
| Health Choices | $57 | 45% |
| Healthcare Management Admin | $57 | 45% |
| Insight | $57 | 45% |
| Intercare | $57 | 45% |
| Jfp Benefit Management | $57 | 45% |
| Jp Farley Corporation | $57 | 45% |
| Key Benefit Administrator | $57 | 45% |
| Liberty Union Life Assurance Co | $57 | 45% |
| Lucent Health | $57 | 45% |
| Luminare Health | $57 | 45% |
| Magnacare | $57 | 45% |
| Medcost | $57 | 45% |
| Mutual Health Services | $57 | 45% |
| Mutual Of Omaha | $57 | 45% |
| Ncas | $57 | 45% |
| Nippon Life Ins | $57 | 45% |
| Nova | $57 | 45% |
| Painters Union Insurance Fund | $57 | 45% |
| Physicians Mutual | $57 | 45% |
| Plumbers Local 98 Insurance Fund | $57 | 45% |
| Prairie States | $57 | 45% |
| Preferred One | $57 | 45% |
| Primary Physician Care | $57 | 45% |
| Professional Benefit Administrators | $57 | 45% |
| Secureone Preferred United Plans | $57 | 45% |
| Siho Insurance Services | $57 | 45% |
| Sisco Benefits | $57 | 45% |
| The Loomis Company | $57 | 45% |
| Trustmark Small Business Benefits | $57 | 45% |
| U Of M Health Plan | $57 | 45% |
| Unicare | $57 | 45% |
| Unified Group Services | $57 | 45% |
| Us Health And Life | $57 | 45% |
| Valenz | $57 | 45% |
| Varipro | $57 | 45% |
| Wps | $57 | 45% |
| Humana | $62 - $122 | 49% |
| First Health | $64 | 51% |
| Paramount Hmo | $64 | 51% |
| American Postal Workers Secondary | $68 | 54% |
| Cigna | $68 | 54% |
| Health Partners | $68 | 54% |
| Healthgram | $68 | 54% |
| Mvp | $68 | 54% |
| Priority Health | $68 | 54% |
| Medben | $73 - $92 | 58% |
| Medicare (plans) | $73 - $87 | 58% |
| Oscar | $73 | 58% |
| Consociate | $75 | 59% |
| Health Ohio Network | $75 | 59% |
| Blue Cross Blue Shield | $82 - $122 | 65% |
| UnitedHealthcare | $83 - $207 | 66% |
| The Health Plan | $85 | 67% |
| Healthlink Inc | $92 | 73% |
| Medical Benefits Mutual | $92 | 73% |
| Ohio Health Choice | $92 | 73% |
| Ohio Ppo Connect | $92 | 73% |
| Medi Share | $97 | 77% |
| Multiplan | $97 | 77% |
| Phcs | $97 | 77% |
| Philadelphia American Life Insurance | $97 | 77% |
| Ameriben | $98 | 78% |
| Luminare Health (Detroit) | $98 | 78% |
| Ohiohealthy | $98 | 78% |
| Osu Not Independent Choice | $98 | 78% |
| Twin Valley Psychiatric | $98 | 78% |
| Health Smart | $104 | 82% |
| Medicaid / KanCare | $122 | 97% |
| Rural Carrier Health Benefit Plan | $150 | 119% |
| Medical Mutual | $152 - $220 | 120% |
| Enterprise Group Planning | $161 | 128% |
| Custom Design Benefits | $174 | 138% |
| Quality Care Partners | $188 | 149% |
| Western & Southern Financial Group | $220 | 174% |