CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Holy Family Memorial

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $339
  • Cash Discount Price: $321
  • vs. Medicare Baseline: 2.16x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Holy Family Memorial is $339. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $321. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 2.16x the Medicare baseline. Located in 2300 Western Ave, Manitowoc, WI.
Cash / Self-Pay
$321

Average discount available for prompt cash payment at this facility.

Insurance Median
$339

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: $321 (204%)
Insurance Median: $339 (216%)
Cash: $321 (204% of Medicare)
Ins. Median: $339 (216% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 216% of the Medicare baseline (a markup of 116%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Network Health Plan $126 - $147 80%
UnitedHealthcare $135 - $203 86%
Blue Cross Blue Shield $147 - $182 94%
Community Care Incorporated $147 94%
Health Partners $147 - $379 94%
Humana $147 94%
Icare $147 94%
Molina $147 - $159 94%
Security Health Plan $147 - $466 94%
Allwell $150 96%
Medical College Of Wisconsin $192 122%
Centivo $233 - $268 148%
Dean Health Plan $292 186%
Health Payment Systems $329 210%
Sheboygan Employers Health Network $350 223%
Chorus Community Health Plan $375 239%
Trilogy $385 245%
Cigna $420 268%
Wps Health Plan $431 275%
Aspirus $466 297%
Healtheos $466 297%
Multiplan/Private Healthcare Systems $466 297%
Preferred One $466 297%
Healthsmart $484 308%
First Health Network $513 327%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2300 Western Ave, Manitowoc, WI 54221
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals