CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Freestone Medical Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $160
  • Cash Discount Price: $326
  • vs. Medicare Baseline: 1.27x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Freestone Medical Center is $160. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $326. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.27x the Medicare baseline. Located in 125 Newman St, Fairfield, TX.
Cash / Self-Pay
$326

Average discount available for prompt cash payment at this facility.

Insurance Median
$160

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: $326 (258%)
Insurance Median: $160 (127%)
Cash: $326 (258% of Medicare)
Ins. Median: $160 (127% 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
Blue Cross Blue Shield $52 - $479 41%
Mcaid $84 - $112 67%
Misc Mcaid Hmo $84 - $160 67%
Superior Health Chip $84 - $112 67%
Tx Childrens Mcaid $84 - $112 67%
UnitedHealthcare $84 - $160 67%
Aarp Mcare /Wellmed $85 67%
Aetna $85 - $426 67%
Allwell Superior Hlth $85 67%
Ambetter / Centene $85 67%
Care Improvement Plus $85 67%
Humana $85 - $532 67%
Medicare (plans) $85 67%
Misc Mcare Replacement $85 67%
Pphp Prov Part Hlth Plan $85 67%
Scott & White Senior Care $85 67%
Superior Hlth Mcare Repl $85 67%
Tricare $85 - $87 67%
Triwest Va Ccn Claims $85 - $87 67%
Utmb Corr Mgd Care $85 67%
Va Vha Office Comm Care $85 67%
Wellmed $85 67%
Champva $87 69%
Triwest $87 69%
Veteran'S Administration $87 69%
Medicaid / KanCare $88 - $246 70%
Superior Health Mcd $88 - $246 70%
Scott & White Commercial $109 86%
Scott & White Employees $109 86%
Amerigroup $110 - $160 87%
Rightcare S&W Mcaid $111 - $160 88%
Aarp $130 103%
Apwu $130 103%
Fringe Benefits $130 103%
Geha $130 103%
Uhcss $130 103%
Workers Compensation $174 138%
Gilsbar $199 - $532 158%
Cigna $239 - $320 189%
Misc Multiplan $279 - $373 221%
Misc Multiplan Auto $279 - $373 221%
Misc Multiplan Workcomp $279 - $373 221%
Self Pay Gt 083123 $279 - $373 221%
Self Pay Lt 090123 $279 - $373 221%
Aflac $399 - $532 316%
Bankers Life $399 - $532 316%
Fairview Nursing Home $399 - $532 316%
Icare $399 - $532 316%
Inmate Freestone Co $399 - $532 316%
Misc Hospice $399 - $532 316%
Miscellaneous $399 - $532 316%
Miscellaneous Auto $399 - $532 316%
Mutual Of Omaha $399 - $532 316%
North American Med Empl $399 - $532 316%
Standard Life Insurance $399 - $532 316%
Tml $399 - $532 316%
Zelis Healthcare $399 - $532 316%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 125 Newman St, Fairfield, TX 75840
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals