CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: St Marys Hospital Superior

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $184
  • Cash Discount Price: $338
  • vs. Medicare Baseline: 1.46x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at St Marys Hospital Superior is $184. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $338. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.46x the Medicare baseline. Located in 3500 Tower Ave, Superior, WI.
Cash / Self-Pay
$338

Average discount available for prompt cash payment at this facility.

Insurance Median
$184

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: $338 (268%)
Insurance Median: $184 (146%)
Cash: $338 (268% of Medicare)
Ins. Median: $184 (146% 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.

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 $92 73%
Primewest $94 74%
Advocare/Security Health $146 116%
Blue Cross Blue Shield $146 - $367 116%
Freedom Blue Ppo $146 116%
Healthpartners Care Msho / Mcr Adv $146 116%
Imcare Msho Pcc Prime $146 116%
Imcare Msho Ref Req $146 116%
Medica Advantage Solutions $146 116%
Medica Msho/Dual Solutions $146 116%
Medica Prime Solution Group $146 116%
Medica Uplan $146 116%
Medicare (plans) $146 116%
Nd Va Administration $146 116%
Platinum Blue/Vantage Blue $146 116%
Primewest Msho $146 116%
Secure Blue Msho $146 116%
Ubh Cost Plan $146 116%
Ubh Msho $146 116%
Ucare Msho $146 116%
UnitedHealthcare $146 - $414 116%
Blue Plus Pmap Pcc Prime $175 139%
Healthpartners Care Pmap $184 146%
Medica Access $184 146%
Sanford Healthplan $196 155%
Ucare $301 238%
Healthpartners $309 - $356 245%
Medica $321 - $357 254%
Wea $329 - $352 261%
Security Health $352 279%
America'S Ppo $354 280%
Cigna $356 282%
Healthpartners Pcc Prime $356 282%
Medica Choice $367 291%
Wps $384 304%
Aetna $388 307%
Healtheos $393 311%

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