CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Gundersen Moundview Hospital and Clinics

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $337
  • Cash Discount Price: $345
  • vs. Medicare Baseline: 2.15x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Gundersen Moundview Hospital and Clinics is $337. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $345. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 2.15x the Medicare baseline. Located in 402 W Lake St, Friendship, WI.
Cash / Self-Pay
$345

Average discount available for prompt cash payment at this facility.

Insurance Median
$337

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: $345 (220%)
Insurance Median: $337 (215%)
Cash: $345 (220% of Medicare)
Ins. Median: $337 (215% 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 215% of the Medicare baseline (a markup of 115%). 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
Amerigroup $20 13%
Blue Cross Blue Shield $145 - $2,594 92%
Iowa Total Care $145 92%
Managed Health Service $145 92%
UnitedHealthcare $153 97%
Alliance $186 - $639 118%
Health Partners $310 - $594 197%
Security Health Plan $310 197%
Ucare $310 - $538 197%
Quartz $367 234%
Wps $519 331%
Wps - Arise $519 331%
Aspirus Arise Health $559 356%
Humana $572 364%
Multiplan/Healtheos $592 - $646 377%
Coventry Health Care $639 407%
Dean Health Plan $1,095 698%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 402 W Lake St, Friendship, WI 53934
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals