CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: St Joseph's Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $543
  • Cash Discount Price: $529
  • vs. Medicare Baseline: 3.46x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at St Joseph's Hospital is $543. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $529. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 3.46x the Medicare baseline. Located in 12866 Troxler Avenue, Highland, IL.
Cash / Self-Pay
$529

Average discount available for prompt cash payment at this facility.

Insurance Median
$543

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: $529 (337%)
Insurance Median: $543 (346%)
Cash: $529 (337% of Medicare)
Ins. Median: $543 (346% 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 346% of the Medicare baseline (a markup of 246%). 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
Molina Healthcare $96 - $735 61%
Meridian Health Plan $101 64%
Illinois Breast and Cervical Cancer Program $112 71%
Clear Spring Health of Illinois $132 - $735 84%
Aetna $132 - $735 84%
Blue Cross Blue Shield $132 - $735 84%
UnitedHealthcare $132 - $735 84%
Humana $132 - $735 84%
Sae Hospice $147 - $735 94%
Amish Community $206 131%
Naphcare $309 - $1,544 197%
Cigna $315 201%
Celtic Insurance Company $323 - $735 206%
Hopetrust $368 - $735 234%
Claim Doc $368 - $1,838 234%
Caterpillar, Inc. $377 240%
Wellfirst $471 300%
First Health $543 346%
Multiplan/Phcs $625 398%
Healthlink $625 398%
Healthcare Finest Network (Hfn) $662 422%
Health Alliance Medical Plans $662 - $735 422%
Provider Network of America $662 422%
Qtc Medical Group of Illinois $735 468%
Consociate Group $735 468%
Current Health Solutions $735 468%
Healthscope $735 468%
Mental Health Network $735 468%
Interplan $735 468%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 12866 Troxler Avenue, Highland, IL 62249
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Critical Access Hospitals