CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Ascension Seton Edgar B Davis

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $122
  • Cash Discount Price: $265
  • vs. Medicare Baseline: 0.78x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Ascension Seton Edgar B Davis is $122. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $265. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 0.78x the Medicare baseline. Located in 130 Hays Street, Luling, TX.
Cash / Self-Pay
$265

Average discount available for prompt cash payment at this facility.

Insurance Median
$122

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: $265 (169%)
Insurance Median: $122 (78%)
Cash: $265 (169% of Medicare)
Ins. Median: $122 (78% 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
Addr Cancer Together $113 72%
Aetna $113 - $1,112 72%
Ambetter / Centene $113 72%
Connected Senior Care $113 72%
Devoted Health Mcr Replacement $113 72%
Humana $113 - $204 72%
Mdsave $113 72%
Medicare (plans) $113 72%
Pphp Mcr Advantage $113 72%
Sendero Chap $113 72%
Sendero Idealcare $113 72%
Smarthealth $113 72%
Superior Allwell $113 72%
UnitedHealthcare $113 72%
Wellcare Med Advantage $115 73%
Blue Cross Blue Shield $120 - $488 76%
Community Health Services $123 78%
Champva $125 - $165 80%
Cigna $395 252%
Covenant Health $1,112 708%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 130 Hays Street, Luling, TX 78648
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals