CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Dickenson Community Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $92
Cash Discount Price: $71
vs. Medicare Baseline: 0.73x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Dickenson Community Hospital is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $71. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.73x the Medicare baseline. Located in 312 Hospital Drive, Clintwood, VA.

Cash / Self-Pay

$71

Average discount available for prompt cash payment at this facility.

Insurance Median

$92

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: $71 (56%)

Insurance Median: $92 (73%)

Cash: $71 (56% of Medicare)

Ins. Median: $92 (73% 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
Optima Health	$43 - $85	34%
UnitedHealthcare	$43 - $316	34%
Aetna	$44 - $253	35%
Blue Cross Blue Shield	$44 - $221	35%
Molina Healthcare	$44 - $93	35%
Ambetter / Centene	$90	71%
Amerigroup	$90	71%
Managed Medicaire	$90	71%
Medicare (plans)	$90	71%
Sentara Health	$90 - $117	71%
United Mine Workers Of America	$90	71%
Humana	$91	72%
Cigna	$94 - $173	74%
Devoted Health Plan	$94	74%
Nhc Advantage	$94	74%
Medcost	$105 - $111	83%
Seven Corners, Inc.	$301 - $316	238%

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 $71.
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 Dickenson 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.