CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Intermountain Health Sanpete Valley Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $786
  • Cash Discount Price: $621
  • vs. Medicare Baseline: 5.01x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Intermountain Health Sanpete Valley Hospital is $786. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $621. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 5.01x the Medicare baseline. Located in 1100 South Medical Drive, Mount Pleasant, UT.
Cash / Self-Pay
$621

Average discount available for prompt cash payment at this facility.

Insurance Median
$786

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: $621 (396%)
Insurance Median: $786 (501%)
Cash: $621 (396% of Medicare)
Ins. Median: $786 (501% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 501% of the Medicare baseline (a markup of 401%). 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 $46 - $794 29%
American Health $46 - $248 29%
Blue Cross Blue Shield $46 - $786 29%
Health Partners Of Nevada $46 - $248 29%
Health Plan Of Nevada $46 - $736 29%
Healthy U $46 - $736 29%
Humana $46 - $786 29%
Molina $46 - $786 29%
Selecthealth $46 - $786 29%
UnitedHealthcare $46 - $786 29%
Ut Cancer Control $150 96%
Triwest $258 - $747 164%
Awh Connected $339 - $794 216%
Byu Athletics $339 - $786 216%
Campbell Scientific $339 - $786 216%
Cigna $339 - $786 216%
Deseret Mutual $339 - $786 216%
Emi $339 - $786 216%
Emi Health $339 - $786 216%
Franklin County $339 - $786 216%
Health Utah $339 - $786 216%
Ifit $339 - $786 216%
Juniper Systems $339 - $786 216%
Lw Miller $339 - $786 216%
Managed Care Admin $339 - $786 216%
Motivhealth $339 - $786 216%
Pehp $339 - $786 216%
Prodegi Corp Benefit $339 - $786 216%
Tanner Llc $339 - $786 216%
Utah Tech $339 - $786 216%
Wise Network $339 - $786 216%
Injury Care Of Nevada $621 396%
Byu Risk Management $703 448%
Corporation Of The President $703 448%
Corvel Corporation $703 448%
Wcf Insurance $703 448%
Global Excel $786 501%
Hygeia Corporation $786 501%
Medcare International $786 501%
Springtide $786 501%
Uofu $786 501%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1100 South Medical Drive, Mount Pleasant, UT 84647
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals