CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Carilion Stonewall Jackson Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $526
  • Cash Discount Price: $287
  • vs. Medicare Baseline: 3.35x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Carilion Stonewall Jackson Hospital is $526. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $287. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 3.35x the Medicare baseline. Located in 1 Health Circle, Lexington, VA.
Cash / Self-Pay
$287

Average discount available for prompt cash payment at this facility.

Insurance Median
$526

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: $287 (183%)
Insurance Median: $526 (335%)
Cash: $287 (183% of Medicare)
Ins. Median: $526 (335% 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 335% of the Medicare baseline (a markup of 235%). 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
Blue Cross Blue Shield $160 102%
Sentara Health Plan $163 - $508 104%
UnitedHealthcare $168 - $670 107%
Abh of Wva (Formerly Coventry) $168 107%
Abh of VA (Formerly Coventry) $168 107%
Humana $168 107%
Aetna $417 - $544 266%
Gateway - Tier 3 $451 287%
Vhn - Ultra $508 324%
Connecticare $574 366%
Vhn - Plus $656 418%
Gateway - Tier 2 $656 418%
Cigna $657 419%
Integrated Health Plan $697 444%
Vhn $697 444%
Vhn - Link $738 470%
Beech Street $754 480%
Gateway - Tier 1 $779 496%
Vhn - Secondary Payors $779 496%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1 Health Circle, Lexington, VA 24450
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals