CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: St Josephs Community Hospital West Bend

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $212
  • Cash Discount Price: $185
  • vs. Medicare Baseline: 1.35x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at St Josephs Community Hospital West Bend is $212. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $185. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.35x the Medicare baseline. Located in 3200 Pleasant Valley Road, West Bend, WI.
Cash / Self-Pay
$185

Average discount available for prompt cash payment at this facility.

Insurance Median
$212

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: $185 (118%)
Insurance Median: $212 (135%)
Cash: $185 (118% of Medicare)
Ins. Median: $212 (135% 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.

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
Centivo $101 - $111 64%
UnitedHealthcare $111 - $203 71%
Network Health Plan $126 - $147 80%
Froedtert South $141 90%
Chorus Community Health Plan $144 92%
Allwell $147 94%
Blue Cross Blue Shield $147 - $286 94%
Community Care $147 94%
Health Partners $147 - $218 94%
Humana $147 94%
Icare $147 94%
Molina $147 94%
Security Health Plan Secure Savers $147 94%
Aetna $150 - $235 96%
Care Wisconsin $152 97%
Sheboygan Employers Health Network $163 104%
Common Ground $202 129%
Health Payment Systems $212 - $272 135%
Wisconsin Physician Services $269 171%
Trilogy $276 176%
Americas Choice $292 186%
Healtheos $292 186%
Multiplan/Private Healthcare Systems $292 186%
First Health Network $296 189%
Hfn $302 192%
Ibsi Passport $302 192%
Cigna $319 203%
Healthsmart $319 203%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3200 Pleasant Valley Road, West Bend, WI 53095
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals