CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Gundersen St Josephs Hospital and Clinics

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $260
Cash Discount Price: $285
vs. Medicare Baseline: 1.66x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Gundersen St Josephs Hospital and Clinics is $260. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $285. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.66x the Medicare baseline. Located in 400 Water Ave, Hillsboro, WI.

Cash / Self-Pay

$285

Average discount available for prompt cash payment at this facility.

Insurance Median

$260

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: $285 (182%)

Insurance Median: $260 (166%)

Cash: $285 (182% of Medicare)

Ins. Median: $260 (166% 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.

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
Amerigroup	$20	13%
Security Health Plan	$96	61%
Blue Cross Blue Shield	$124 - $261	79%
Iowa Total Care	$124	79%
Managed Health Service	$124	79%
Alliance	$186 - $838	118%
Ucare	$255 - $393	162%
UnitedHealthcare	$260 - $343	166%
Quartz	$268	171%
Cigna	$403	257%
Aspirus Arise Health	$408	260%
Humana	$417	266%
Multiplan/Healtheos	$427 - $466	272%
Coventry Health Care	$466	297%

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 $285.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77066.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Gundersen St Josephs Hospital and Clinics is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77066.
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.