CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Charleston Area Medical Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $140
Cash Discount Price: $459
vs. Medicare Baseline: 1.11x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Charleston Area Medical Center is $140. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $459. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.11x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$459

Average discount available for prompt cash payment at this facility.

Insurance Median

$140

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: $459 (364%)

Insurance Median: $140 (111%)

Cash: $459 (364% of Medicare)

Ins. Median: $140 (111% 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.

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
Blue Cross Blue Shield	$24 - $488	19%
Choicecare Network	$24 - $524	19%
Triwest Va	$24 - $130	19%
The Health Plan Of West Virginia Inc.	$25 - $519	20%
UnitedHealthcare	$25 - $524	20%
West Virginia Senior Advantage Inc.	$25 - $140	20%
Integrated Medical Solutions	$47 - $261	37%
Naphcare	$48 - $268	38%
Tricare	$58 - $321	46%
Caresource	$61 - $334	48%
Aetna	$67 - $524	53%
Unicare Health Plan Of West Virginia Inc.	$67 - $135	53%
City Of Charleston	$73 - $401	58%
Cigna	$90 - $498	71%
Three Rivers Providers Network	$94 - $519	74%
Healthsmart	$95 - $524	75%
Multiplan	$95 - $524	75%
Breast & Cervical Cancer Screening Program	$97 - $120	77%
Optimum Choice Inc.	$97 - $214	77%

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 $459.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77067.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Charleston Area Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77067.
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.