CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: St Josephs Community Hospital West Bend

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $235
  • Cash Discount Price: $205
  • vs. Medicare Baseline: 1.86x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at St Josephs Community Hospital West Bend is $235. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $205. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.86x the Medicare baseline. Located in 3200 Pleasant Valley Road, West Bend, WI.
Cash / Self-Pay
$205

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: $205 (162%)
Insurance Median: $235 (186%)
Cash: $205 (162% 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
Centivo $112 - $123 89%
Allwell $119 94%
Blue Cross Blue Shield $119 - $317 94%
Community Care $119 94%
Health Partners $119 - $242 94%
Humana $119 94%
Icare $119 94%
Molina $119 94%
Network Health Plan $119 - $140 94%
Security Health Plan Secure Savers $119 94%
UnitedHealthcare $119 - $203 94%
Aetna $122 - $261 97%
Care Wisconsin $123 97%
Froedtert South $157 124%
Chorus Community Health Plan $160 127%
Sheboygan Employers Health Network $163 129%
Common Ground $224 177%
Health Payment Systems $235 - $302 186%
Wisconsin Physician Services $298 236%
Trilogy $306 242%
Americas Choice $325 257%
Healtheos $325 257%
Multiplan/Private Healthcare Systems $325 257%
First Health Network $328 260%
Hfn $336 266%
Ibsi Passport $336 266%
Cigna $354 280%
Healthsmart $354 280%

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