CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Clarion Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $145
  • Cash Discount Price: $239
  • vs. Medicare Baseline: 1.15x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Clarion Hospital is $145. 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 1.15x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.
Cash / Self-Pay
$239

Average discount available for prompt cash payment at this facility.

Insurance Median
$145

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: $145 (115%)
Cash: $239 (189% of Medicare)
Ins. Median: $145 (115% 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
Highmark $82 - $145 65%
Amerihealth $83 - $115 66%
Cigna $83 - $214 66%
Highmark Community Blue $83 66%
Martin'S Point - Usfhp $83 - $149 66%
Medicare (plans) $83 66%
Tricare $83 66%
UnitedHealthcare $83 66%
Aetna $86 - $380 68%
Geisinger $87 - $126 69%
Devoted Health Plan $88 - $171 70%
The Health Plan $88 - $195 70%
Gateway $89 - $158 70%
Pa Health & Wellness $89 70%
American Health Plan $91 72%
Upmc $92 - $433 73%
Medicaid / KanCare $105 83%
Jefferson Health Plan $115 91%
Highmark - Ind.& Managed Care $145 - $186 115%
Peak Health $195 - $299 154%
Devon $320 253%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals