CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: St John Owasso

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $83
Cash Discount Price: $141
vs. Medicare Baseline: 0.66x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at St John Owasso is $83. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $141. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.66x the Medicare baseline. Located in 12451 East 100Th Street North, Owasso, OK.

Cash / Self-Pay

$141

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: $141 (112%)

Insurance Median: $83 (66%)

Cash: $141 (112% 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
Champva	$80	63%
Community Care - St John Network Senior - Govt	$80	63%
Communitycare Senior	$80	63%
Life Pace	$80	63%
Longevity Health Plan Of Oklahoma	$80	63%
Medicare (plans)	$80	63%
UnitedHealthcare	$80 - $82	63%
Va Community Care Network	$80	63%
Veterans Administration	$80	63%
Humana	$81	64%
Blue Cross Blue Shield	$84 - $245	67%
Communitycare (Standard)	$88	70%
Community Care (Select) 7/1/13	$96	76%
Aetna	$101	80%
Ccl&H	$104	82%
Smarthealth	$112	89%
Community Care Smarthealth	$120 - $192	95%
Communitycare (Select)	$120 - $184	95%
Connect Health Benefit	$160	127%
Evolutions	$160	127%
Kempton Group Administrators	$180	143%

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 $141.
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 St John Owasso 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.