CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: SSM Health St Agnes Hospital-Fond Du Lac

Billing Code: 77067 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$141
about 1.1× the $126 Medicare rate · typically $85–$191
modeled estimate · not a bill or quote
What this hospital charges insurers
$89
Below the fair price — a good deal
about $52 under the fair price · 0.7× Medicare
Medicare pays $126 Fair price $141 This hospital $89 Cash price $163 Hospital's list price $297

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 $34 Priciest $89

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

A fair price for a Screening mammogram (both breasts) is about $141 (about 1.1× the $126 Medicare rate). SSM Health St Agnes Hospital-Fond Du Lac charges insurers about $89, or about $163 in cash — below the fair price — a good deal. Located in Fond Du Lac, WI.

What each insurance company pays

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

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

✓ Blue Cross Blue Shield UnitedHealthcareAetnaCignaHumanaKaiser 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
Blue Cross Blue Shieldmajor $87 - $121 69%
Molina $65 51%
WellCare $89 70%
+ 1 smaller / regional plan $168

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Facility Profile & Credentials

  • Address: 430 E Division St, Fond Du Lac, WI 54935
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals