CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Fort Memorial Hospital

Billing Code: 77066 (CPT)

The BaseRate · fair price high confidence

A fair price for this

$104

about 0.7× the $157 Medicare rate · typically $83–$136

modeled estimate · not a bill or quote

What this hospital charges insurers

$106

About the fair price

about $2 over the fair price · 0.7× Medicare

Medicare pays $157 Fair price $104 This hospital $106 Cash price $108 Hospital's list price $337

How we calculate the fair BaseRate →

How this hospital compares to other WI hospitals

Highest price of the 9 WI hospitals we have prices for — worth calling around.

Cheapest $45 Priciest $106

Black dot = this hospital, among the 9 WI hospitals with a price for this procedure. Full list below.

A fair price for a Diagnostic mammogram (both breasts) is about $104 (about 0.7× the $157 Medicare rate). Fort Memorial Hospital charges insurers about $106, or about $108 in cash — about the fair price. Located in Fort Atkinson, WI.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$20 - $211	13%
Blue Cross Blue Shieldmajor	$19 - $300	12%
Aetnamajor	$71 - $407	45%
Cignamajor	$118 - $516	75%
Humanamajor	$44 - $156	28%
Dean Health Plan	$19 - $356	12%
Molina	$40 - $158	25%
Quartz	$19 - $1,101	12%
+ 8 smaller / regional plans	$21 - $500

Government programs also on file: Medicaid.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 108), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 77066.

Insurance Before you use insurance

Call your insurance company to confirm Fort Memorial Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 77066.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Fort Memorial Hospital

Compare: Diagnostic mammogram (both breasts) at other WI hospitals

Insurance negotiated median for the same procedure, sorted lowest first.