CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Memorial Medical Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $225
  • Cash Discount Price: $287
  • vs. Medicare Baseline: 1.78x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Memorial Medical Center is $225. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $287. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.78x the Medicare baseline. Located in 701 N Virginia St, Port Lavaca, TX.
Cash / Self-Pay
$287

Average discount available for prompt cash payment at this facility.

Insurance Median
$225

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: $287 (227%)
Insurance Median: $225 (178%)
Cash: $287 (227% of Medicare)
Ins. Median: $225 (178% 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
Triwest Va Pccc-All Plans $97 - $129 77%
Amerigroup Mcr Adv-All Other Plans $99 - $131 78%
Care Improvement Plus - All Other Plans $99 - $131 78%
Coventry First Hlth Mcr Adv $99 - $131 78%
Multiplan Mcr Adv $99 - $131 78%
Superior Allwell Mcr Adv-All Other Plans $99 - $131 78%
UnitedHealthcare $99 - $375 78%
Universal American Mcr-All Other Plans $99 - $131 78%
Care Improvement Plus Mcr $100 - $133 79%
Universal American Snp $103 - $138 82%
Ambetter / Centene $118 - $158 93%
Amerigroup Chip $169 - $225 134%
Amerigroup Star $169 - $225 134%
Amerigroup Star Kids $169 - $225 134%
Amerigroup Star Plus $169 - $225 134%
Comm Health Chip $169 - $225 134%
Comm Health Perinatal-All Other Plans $169 - $225 134%
Molina Chip/Star-All Plans $169 - $225 134%
Scott & White Chip/Star-All Plans $169 - $225 134%
Superior Chip/Star $169 - $225 134%
Texas Childrens Hp - All Plans $169 - $225 134%
Comm Health Mcaid Hmo $177 - $236 140%
Comm Health Star $177 - $236 140%
Prime Healthcare Services-All Plans $246 - $328 195%
Cigna $264 - $352 209%
Aetna $282 - $375 223%
Capstar Health Network-All Plans $282 - $375 223%
Coventry First Hlth Hmo Ppo-All Other Plans $282 - $375 223%
Healthcare Highways-All Plans $282 - $375 223%
Humana $282 - $375 223%
Corvel Work Comp-All Plans $299 - $399 237%
Galaxy Health Network-All Plans $299 - $399 237%
Independent Med Sys Ppo-All Plans $299 - $399 237%
Multiplan Phcs Ppo-All Other Plans $299 - $399 237%
Provider Select Ppo-All Plans $299 - $399 237%
Three Rivers Ppo-All Plans $299 - $399 237%
Usa Mso - All Plans $299 - $399 237%

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