CMS Price Transparency Data
Screening mammogram (both breasts)
Facility: Mercy Hospital Ada
Billing Code: 77067 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 77067
- Insurance Median: $176
- Cash Discount Price: $239
- vs. Medicare Baseline: 1.39x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Mercy Hospital Ada is $176. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $239. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.39x the Medicare baseline. Located in 430 North Monte Vista, Ada, OK.
Cash / Self-Pay
$239
Average discount available for prompt cash payment at this facility.
Insurance Median
$176
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: $239 (189%)
Insurance Median: $176 (139%)
Cash: $239 (189% of Medicare)
Ins. Median: $176 (139% 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 |
|---|---|---|
| Aetna | $77 - $332 | 61% |
| Humana | $77 - $78 | 61% |
| Medicaid / KanCare | $77 - $108 | 61% |
| Blue Cross Blue Shield | $78 | 62% |
| Cherokee Nation Health Serv Contracted [320066] | $78 | 62% |
| Cross Timbers Hospice [20098] | $78 | 62% |
| Dept Of Veteran Affairs Contracted [320106] | $78 | 62% |
| Elara Caring Aspire Hospice Contracted [320433] | $78 | 62% |
| Elara Caring Aspire Hospice [20433] | $78 | 62% |
| Halo Hcr Inc Hospice Contracted [320432] | $78 | 62% |
| Halo Hcr Inc Hospice [20432] | $78 | 62% |
| Independent Health [20197] | $78 | 62% |
| Indian Health Service Contracted [320198] | $78 | 62% |
| Kindful Hospice Contracted [320434] | $78 | 62% |
| Kindful Hospice [20434] | $78 | 62% |
| Medical Associates Health [20444] | $78 | 62% |
| Medicare (plans) | $78 - $441 | 62% |
| Mercy Hospice Okc [20252] | $78 | 62% |
| Provider Partners Health Plans Contracted [320450] | $78 | 62% |
| Qual Choice Contracted [320325] | $78 | 62% |
| Tricare | $78 | 62% |
| UnitedHealthcare | $78 - $162 | 62% |
| Globalhealth Contracted [320145] | $80 | 63% |
| Cigna | $81 | 64% |
| Ambetter / Centene | $108 | 86% |
| Home State Health Plan Contracted [320187] | $108 | 86% |
| Novasys Contracted [320285] | $108 | 86% |
| Healthcare Highways Plus Contracted [320175] | $115 - $331 | 91% |
| Webtpa Contracted [320417] | $123 - $185 | 97% |
| Osma Health Contracted [320292] | $132 - $198 | 105% |
| Medica Contracted [320239] | $137 - $441 | 109% |
| Benefit Management Contracted [320052] | $147 - $287 | 116% |
| United Medical Resources Contracted [320454] | $162 - $265 | 128% |
| Aither Health Contracted [320449] | $176 - $265 | 139% |
| Auxiant Contracted [320462] | $176 - $265 | 139% |
| Ebms Contracted [320493] | $176 - $265 | 139% |
| Federal Medical Center Contracted [320127] | $176 - $265 | 139% |
| Healthlink Contracted [320179] | $176 - $265 | 139% |
| Healthscope Contracted [320182] | $176 - $265 | 139% |
| Healthsmart Preferred Care Contracted [320184] | $176 | 139% |
| Imagine 360 Contracted [320494] | $176 - $265 | 139% |
| Kempton Contracted [320214] | $176 | 139% |
| Mercy Benefit Admin Contracted [320251] | $176 - $287 | 139% |
| Point C Contracted [320238] | $176 - $265 | 139% |
| Preferred Health Plan Contracted [320522] | $176 - $265 | 139% |
| Quik Trip Contracted [320447] | $176 - $265 | 139% |
| Reflect Health Contracted [320492] | $176 - $265 | 139% |
| Show-Me Health Administrators Contracted [320483] | $176 - $265 | 139% |
| Yuzu Health Contracted [320521] | $176 - $265 | 139% |
| Globalhealth Contracted [320144] | $185 - $278 | 147% |
| Health Choice Contracted [320166] | $225 | 178% |
| First Health Contracted [320128] | $244 - $366 | 193% |
| Multiplan Contracted [320270] | $250 - $375 | 198% |
| Private Health Care Systems Contracted [320320] | $250 - $375 | 198% |
| Workers Comp [20426] | $265 | 210% |