CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Southwest Health Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $341
Cash Discount Price: $330
vs. Medicare Baseline: 2.70x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Southwest Health Center is $341. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $330. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.70x the Medicare baseline. Located in 1400 East Side Rd, Platteville, WI.

Cash / Self-Pay

$330

Average discount available for prompt cash payment at this facility.

Insurance Median

$341

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: $330 (261%)

Insurance Median: $341 (270%)

Cash: $330 (261% of Medicare)

Ins. Median: $341 (270% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 270% of the Medicare baseline (a markup of 170%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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	$130 - $447	103%
Care Wisconsin	$130 - $291	103%
UnitedHealthcare	$135 - $367	107%
Quartz	$269 - $349	213%
Dean Health Plan	$309 - $319	245%
Cigna	$326 - $335	258%
Wps	$326 - $335	258%
Group Health Cooperative of Sc	$347 - $389	275%
Humana	$391 - $402	310%
Healthchoice	$412 - $425	326%
Group Health Eau Claire	$434 - $447	344%
Group Health South Central	$434 - $447	344%

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 $330.
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 Southwest Health 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.