CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Lewisgale Hospital Alleghany

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $234
Cash Discount Price: $642
vs. Medicare Baseline: 1.85x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Lewisgale Hospital Alleghany is $234. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $642. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.85x the Medicare baseline. Located in One Arh Lane - Po Box 7, Low Moor, VA.

Cash / Self-Pay

$642

Average discount available for prompt cash payment at this facility.

Insurance Median

$234

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: $642 (509%)

Insurance Median: $234 (185%)

Cash: $642 (509% of Medicare)

Ins. Median: $234 (185% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Triatlantic	$75	59%
Health Net	$79	63%
Humana	$85 - $90	67%
Aetna	$90 - $347	71%
Devoted	$90	71%
Good Samaritan Hospice	$90	71%
Sentara Health	$90	71%
United	$90 - $289	71%
United Behavioral Health	$90	71%
United Mine Workers	$90	71%
Virginia Premier Health	$91	72%
Blue Cross Blue Shield	$92 - $748	73%
Cigna	$93	74%
Clear Spring Health Plan	$94	74%
Align Senior Care	$96	76%
Lifeworks	$122	97%
Universal Healthcare Group	$141	112%
Virginia Health Network	$225 - $456	178%
Greenvbrier Sporting Club	$385	305%
Corvel	$462	366%
Csx Hotels	$514	407%
Occunet Workers Comp	$514	407%
Health Payors Organization	$546	432%
4Most	$578	458%
Alleghany Highland Community	$578	458%
American Postal Workers Union	$578	458%
C&O Employees Hospital Assn	$578	458%
Community Care Network	$578	458%
Multiplan	$578	458%
One Health Plan	$578	458%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $642.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77067.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Lewisgale Hospital Alleghany is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77067.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.