CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Wellmont Holston Valley Medical Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $87
Cash Discount Price: $72
vs. Medicare Baseline: 0.69x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Wellmont Holston Valley Medical Center is $87. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $72. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.69x the Medicare baseline. Located in 130 West Ravine Road, Kingsport, TN.

Cash / Self-Pay

$72

Average discount available for prompt cash payment at this facility.

Insurance Median

$87

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: $72 (57%)

Insurance Median: $87 (69%)

Cash: $72 (57% of Medicare)

Ins. Median: $87 (69% 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
UnitedHealthcare	$29 - $494	23%
Blue Cross Blue Shield	$30 - $346	24%
Optima Health	$30 - $60	24%
Aetna	$31 - $211	25%
Molina Healthcare	$31 - $87	25%
Amerigroup	$77 - $86	61%
Humana	$83	66%
Managed Medicaire	$83	66%
Medicare (plans)	$83	66%
Sentara Health	$83 - $128	66%
United Mine Workers Of America	$83	66%
Cigna	$87 - $206	69%
Devoted Health Plan	$87	69%
Mountain Empire Pace	$87	69%
Nhc Advantage	$87	69%
Wellcare	$88 - $494	70%
Ambetter / Centene	$180	143%
Seven Corners, Inc.	$199	158%
Medcost	$223 - $235	177%
First Health Coventry	$361 - $380	286%

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 $72.
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 Wellmont Holston Valley Medical Center 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.