CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Forks Community Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $235
  • Cash Discount Price: $358
  • vs. Medicare Baseline: 1.86x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Forks Community Hospital is $235. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $358. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.86x the Medicare baseline. Located in 530 Bogachiel Way, Forks, WA.
Cash / Self-Pay
$358

Average discount available for prompt cash payment at this facility.

Insurance Median
$235

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: $358 (284%)
Insurance Median: $235 (186%)
Cash: $358 (284% of Medicare)
Ins. Median: $235 (186% 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.

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
Medicaid / KanCare $74 - $250 59%
Coordinated Care (Mco) Mcd-All Plans $80 - $254 63%
UnitedHealthcare $95 - $579 75%
Community Health Network Mcr-All Other Plans $96 - $306 76%
Humana $96 - $306 76%
Tricare $96 - $306 76%
Triwest-All Plans $96 - $306 76%
Ambetter / Centene $112 - $355 89%
Wellcare Med Adv - All Plans $112 - $355 89%
Regence-All Other Plans $123 - $392 97%
Community Health Exchange $139 - $443 110%
Molina Commercial-All Other Plans $197 - $627 156%
Aetna $203 - $647 161%
Blue Cross Blue Shield $203 - $647 161%
Cigna $214 - $681 170%
First Choice-All Plans $214 - $681 170%
Medicare (plans) $318 252%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 530 Bogachiel Way, Forks, WA 98331
  • CMS Rating: No CMS Rating
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Critical Access Hospitals