CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Carilion Giles Community Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $393
Cash Discount Price: $222
vs. Medicare Baseline: 3.11x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Carilion Giles Community Hospital is $393. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $222. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 3.11x the Medicare baseline. Located in 159 Hartley Way, Pearisburg, VA.

Cash / Self-Pay

$222

Average discount available for prompt cash payment at this facility.

Insurance Median

$393

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: $222 (176%)

Insurance Median: $393 (311%)

Cash: $222 (176% of Medicare)

Ins. Median: $393 (311% 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 311% of the Medicare baseline (a markup of 211%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Blue Cross Blue Shield	$129	102%
Sentara Health Plan	$131 - $393	104%
Abh Of Va (Formerly Coventry)	$135	107%
Abh Of Wva (Formerly Coventry)	$135	107%
Humana	$135	107%
UnitedHealthcare	$135 - $518	107%
Aetna	$323 - $421	256%
Gateway - Tier 3	$349	276%
Vhn - Ultra	$393	311%
Cigna	$427 - $456	338%
Connecticare	$444	352%
Vhn - Plus	$488	387%
Gateway - Tier 2	$507	402%
Vhn	$507	402%
Vhn - Link	$571	452%
Gateway - Tier 1	$602	477%
Vhn - Secondary Payors	$602	477%

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 $222.
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 Carilion Giles Community Hospital 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.