CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Unitypoint Health - Meriter

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $92
Cash Discount Price: $270
vs. Medicare Baseline: 0.73x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Unitypoint Health - Meriter is $92. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $270. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.73x the Medicare baseline. Located in 202 S Park St, Madison, WI.

Cash / Self-Pay

$270

Average discount available for prompt cash payment at this facility.

Insurance Median

$92

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: $270 (214%)

Insurance Median: $92 (73%)

Cash: $270 (214% of Medicare)

Ins. Median: $92 (73% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Aspirus	$30 - $163	24%
Blue Cross Blue Shield	$32 - $546	25%
Wellmark Uph Self-Funded	$32 - $546	25%
Illinicare	$34 - $119	27%
Prevea 360	$34 - $396	27%
UnitedHealthcare	$34 - $302	27%
Humana	$35 - $125	28%
Meridiancare	$35 - $125	28%
Cigna	$36 - $130	29%
Security Health Plan	$39 - $140	31%
Mercy Care	$45 - $163	36%
Health Partners Open Network	$77 - $264	61%
Medical Associates Health Plan	$111 - $395	88%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $270.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77067.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Unitypoint Health - Meriter is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77067.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.