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If your AGI is over something like 77K, you get whacked another $100 a month for Medicare.

Not exactly.

If your income, as a single person, is over $85,000, you pay $146.90 instead of $104.90/month for Medicare Part B*--an additional $42/month. (For a couple, the cut-off is income over $170,000.

* Medicare Part A is free for anyone who paid into Medicare for at least 10 years. Medicare supplemental policies and drug policies are additional.

There are a few more high-income levels:

http://www.medicare.gov/your-medicare-costs/part-b-costs/par...
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