CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: St Marys Hospital Superior

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $217
  • Cash Discount Price: $400
  • vs. Medicare Baseline: 1.38x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at St Marys Hospital Superior is $217. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $400. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.38x the Medicare baseline. Located in 3500 Tower Ave, Superior, WI.
Cash / Self-Pay
$400

Average discount available for prompt cash payment at this facility.

Insurance Median
$217

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: $400 (255%)
Insurance Median: $217 (138%)
Cash: $400 (255% of Medicare)
Ins. Median: $217 (138% 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.

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
Itasca Med Care $111 71%
Primewest $114 73%
Advocare/Security Health $173 110%
Blue Cross Blue Shield $173 - $434 110%
Freedom Blue Ppo $173 110%
Healthpartners Care Msho / Mcr Adv $173 110%
Imcare Msho Pcc Prime $173 110%
Imcare Msho Ref Req $173 110%
Medica Advantage Solutions $173 110%
Medica Msho/Dual Solutions $173 110%
Medica Prime Solution Group $173 110%
Medica Uplan $173 110%
Medicare (plans) $173 110%
Nd Va Administration $173 110%
Platinum Blue/Vantage Blue $173 110%
Primewest Msho $173 110%
Secure Blue Msho $173 110%
Ubh Cost Plan $173 110%
Ubh Msho $173 110%
Ucare Msho $173 110%
UnitedHealthcare $173 - $490 110%
Blue Plus Pmap Pcc Prime $208 133%
Healthpartners Care Pmap $217 138%
Medica Access $217 138%
Sanford Healthplan $232 148%
Ucare $356 227%
Healthpartners $366 - $422 233%
Medica $380 - $423 242%
Wea $390 - $417 248%
Security Health $417 266%
America'S Ppo $419 267%
Cigna $422 269%
Healthpartners Pcc Prime $422 269%
Medica Choice $435 277%
Wps $454 289%
Aetna $460 293%
Healtheos $465 296%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3500 Tower Ave, Superior, WI 54880
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals