CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Memorial Medical Center

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $288
  • Cash Discount Price: $420
  • vs. Medicare Baseline: 1.83x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Memorial Medical Center is $288. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $420. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.83x the Medicare baseline. Located in 701 N Virginia St, Port Lavaca, TX.
Cash / Self-Pay
$420

Average discount available for prompt cash payment at this facility.

Insurance Median
$288

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: $420 (268%)
Insurance Median: $288 (183%)
Cash: $420 (268% of Medicare)
Ins. Median: $288 (183% 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
Triwest Va Pccc-All Plans $165 105%
Amerigroup Mcr Adv-All Other Plans $168 107%
Care Improvement Plus - All Other Plans $168 107%
Coventry First Hlth Mcr Adv $168 107%
Multiplan Mcr Adv $168 107%
Superior Allwell Mcr Adv-All Other Plans $168 107%
UnitedHealthcare $168 - $480 107%
Universal American Mcr-All Other Plans $168 107%
Care Improvement Plus Mcr $170 108%
Universal American Snp $176 112%
Ambetter / Centene $202 129%
Amerigroup Chip $288 183%
Amerigroup Star $288 183%
Amerigroup Star Kids $288 183%
Amerigroup Star Plus $288 183%
Comm Health Chip $288 183%
Comm Health Perinatal-All Other Plans $288 183%
Molina Chip/Star-All Plans $288 183%
Scott & White Chip/Star-All Plans $288 183%
Superior Chip/Star $288 183%
Texas Childrens Hp - All Plans $288 183%
Comm Health Mcaid Hmo $302 192%
Comm Health Star $302 192%
Prime Healthcare Services-All Plans $420 268%
Cigna $450 287%
Aetna $480 306%
Capstar Health Network-All Plans $480 306%
Coventry First Hlth Hmo Ppo-All Other Plans $480 306%
Healthcare Highways-All Plans $480 306%
Humana $480 306%
Corvel Work Comp-All Plans $510 325%
Galaxy Health Network-All Plans $510 325%
Independent Med Sys Ppo-All Plans $510 325%
Multiplan Phcs Ppo-All Other Plans $510 325%
Provider Select Ppo-All Plans $510 325%
Three Rivers Ppo-All Plans $510 325%
Usa Mso - All Plans $510 325%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 701 N Virginia St, Port Lavaca, TX 77979
  • CMS Rating: ★★★★☆
  • Ownership Type: Government - Local
  • Hospital Type: Critical Access Hospitals