CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Intermountain Health Delta Community Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $619
  • Cash Discount Price: $695
  • vs. Medicare Baseline: 4.90x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Intermountain Health Delta Community Hospital is $619. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $695. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 4.90x the Medicare baseline. Located in 126 South White Sage Avenue, Delta, UT.
Cash / Self-Pay
$695

Average discount available for prompt cash payment at this facility.

Insurance Median
$619

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: $695 (550%)
Insurance Median: $619 (490%)
Cash: $695 (550% of Medicare)
Ins. Median: $619 (490% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 490% of the Medicare baseline (a markup of 390%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Aetna $36 - $1,154 29%
American Health $36 - $385 29%
Blue Cross Blue Shield $36 - $1,142 29%
Health Partners Of Nevada $36 - $385 29%
Health Plan Of Nevada $36 - $1,070 29%
Healthy U $36 - $1,070 29%
Humana $36 - $385 29%
Molina $36 - $1,142 29%
Selecthealth $36 - $1,142 29%
UnitedHealthcare $36 - $1,142 29%
Ut Cancer Control $86 68%
Triwest $248 - $458 196%
Awh Connected $339 - $1,154 269%
Byu Athletics $339 - $1,142 269%
Campbell Scientific $339 - $1,142 269%
Cigna $339 - $1,142 269%
Deseret Mutual $339 - $1,142 269%
Emi $339 - $1,142 269%
Emi Health $339 - $1,142 269%
Franklin County $339 - $1,142 269%
Health Utah $339 - $1,142 269%
Ifit $339 - $1,142 269%
Juniper Systems $339 - $1,142 269%
Lw Miller $339 - $1,142 269%
Managed Care Admin $339 - $1,142 269%
Motivhealth $339 - $1,142 269%
Pehp $339 - $1,142 269%
Prodegi Corp Benefit $339 - $1,142 269%
Tanner Llc $339 - $1,142 269%
Utah Tech $339 - $1,142 269%
Wise Network $339 - $1,142 269%
Injury Care Of Nevada $488 - $902 387%
Byu Risk Management $553 - $1,022 438%
Corporation Of The President $553 - $1,022 438%
Corvel Corporation $553 - $1,022 438%
Wcf Insurance $553 - $1,022 438%
Global Excel $619 - $1,142 490%
Hygeia Corporation $619 - $1,142 490%
Medcare International $619 - $1,142 490%
Springtide $619 - $1,142 490%
Uofu $619 - $1,142 490%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 126 South White Sage Avenue, Delta, UT 84624
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals