CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Prisma Health Oconee Memorial Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $88
  • Cash Discount Price: $269
  • vs. Medicare Baseline: 0.70x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Prisma Health Oconee Memorial Hospital is $88. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $269. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.70x the Medicare baseline. Located in 298 Memorial Dr, Seneca, SC.
Cash / Self-Pay
$269

Average discount available for prompt cash payment at this facility.

Insurance Median
$88

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: $269 (213%)
Insurance Median: $88 (70%)
Cash: $269 (213% of Medicare)
Ins. Median: $88 (70% 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
First Choice Benefits Mgmt [3074] $49 39%
Medicaid / KanCare $49 - $64 39%
Medicare (plans) $49 - $93 39%
Blue Cross Blue Shield $50 - $165 40%
Humana $52 - $88 41%
Bluechoice [810] $59 - $223 47%
UnitedHealthcare $64 - $94 51%
Bob Jones Univ-Pai [821] $76 60%
Champva [3049] $84 67%
Cigna $84 - $448 67%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $84 67%
Deseret Mutual Ins Co [3066] $84 67%
Generic Skilled Nursing [3196] $84 67%
Hospice Contracted [1500] $84 67%
Hospice Non Contracted [3190] $84 67%
Triwest Healthcare Alliance Vcp [902] $84 67%
Va Community Care Network-Vaccn [903] $84 67%
Veterans Administration [3194] $84 67%
Aetna $88 - $327 70%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $88 70%
Healthy Conn Prime-First Choice Vip Care [5300] $89 70%
Healthy Conn Prime-Molina Healthcare [5330] $93 74%
Golden Rule Insurance Company [2991] $94 74%
Oxford Health Plans [2992] $94 74%
Zzumr-Salt Lake City Ut [3169] $94 74%
Prisma Health Seniorcare Pace - Midlands [5400] $96 76%
Prisma Health Seniorcare Pace-Upstate [5200] $96 76%
Sc Dept Of Corrections [2998] $110 87%
Scdc-Sc Dept Of Corrections [7232] $110 87%
Tricare $115 91%
Workers Comp [600] $118 93%
Promise Health Plan Contracted [2401] $145 - $248 115%
Ambetter / Centene $155 123%
Planned Administrators [820] $165 131%
Orangeburg Senior Helping Center Pace [5401] $166 131%
Meritain Health Contracted [2200] $265 - $327 210%
Preferred Administrators Contracted [2839] $290 230%
Medcost [2940] $306 - $344 242%
Atlantic Packaging Contracted [4833] $310 246%
Aps Healthcare System [2981] $331 262%
Multiplan/Phcs Contracted [2950] $368 291%
Vsp Vision Care [2986] $373 295%
First Health Contracted [2952] $385 305%
Furman Int/Allen University Student [2951] $385 305%
Quiktrip-First Health [3067] $385 305%
Evernorth Behavioral Contracted [2982] $448 355%
Mvp Health Care [3037] $448 355%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 298 Memorial Dr, Seneca, SC 29672
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals