CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Prisma Health Tuomey Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $139
  • Cash Discount Price: $306
  • vs. Medicare Baseline: 0.89x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Prisma Health Tuomey Hospital is $139. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $306. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 0.89x the Medicare baseline. Located in 129 N Washington St, Sumter, SC.
Cash / Self-Pay
$306

Average discount available for prompt cash payment at this facility.

Insurance Median
$139

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$156.98

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $156.98 (100%)
Cash / Self-Pay: $306 (195%)
Insurance Median: $139 (89%)
Cash: $306 (195% of Medicare)
Ins. Median: $139 (89% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $156.98 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
Medicaid / KanCare $49 - $73 31%
Humana $52 - $353 33%
Blue Cross Blue Shield $71 - $368 45%
Bluechoice [810] $71 - $368 45%
UnitedHealthcare $73 - $255 47%
Cigna $102 - $471 65%
Covid19 Hrsa Uninsured Testing & Treatment Fund [904] $102 65%
Medicare (plans) $102 - $107 65%
Triwest Healthcare Alliance Vcp [902] $102 65%
Va Community Care Network-Vaccn [903] $102 65%
Aetna $107 - $372 68%
Healthy Conn Prime-First Choice Vip Care [5300] $107 68%
Healthy Conn Prime-Molina Healthcare [5330] $107 68%
Healthy Conn Prime-Wellcare Prime By Atc [5310] $107 68%
Prisma Health Seniorcare Pace - Midlands [5400] $109 69%
Prisma Health Seniorcare Pace-Upstate [5200] $109 69%
Bob Jones Univ-Pai [821] $134 85%
Workers Comp [600] $143 91%
Tricare $149 95%
Promise Health Plan Contracted [2401] $165 - $283 105%
Ambetter / Centene $188 120%
Orangeburg Senior Helping Center Pace [5401] $188 120%
Scdc-Sc Dept Of Corrections [7232] $188 120%
Golden Rule Insurance Company [2991] $255 162%
Oxford Health Plans [2992] $255 162%
Zzumr-Salt Lake City Ut [3169] $255 162%
Meritain Health Contracted [2200] $301 - $372 192%
Preferred Administrators Contracted [2839] $330 210%
Medcost [2940] $349 - $391 222%
Atlantic Packaging Contracted [4833] $353 225%
Planned Administrators [820] $368 234%
Aps Healthcare System [2981] $377 240%
Multiplan/Phcs Contracted [2950] $419 267%
Vsp Vision Care [2986] $424 270%
First Health Contracted [2952] $438 279%
Furman Int/Allen University Student [2951] $438 279%
Quiktrip-First Health [3067] $438 279%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 129 N Washington St, Sumter, SC 29150
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals