CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Adventist Health St Helena

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $519
Cash Discount Price: $99
vs. Medicare Baseline: 3.31x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Adventist Health St Helena is $519. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $99. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 3.31x the Medicare baseline. Located in 10 Woodland Road, Saint Helena, CA.

Cash / Self-Pay

$99

Average discount available for prompt cash payment at this facility.

Insurance Median

$519

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: $99 (63%)

Insurance Median: $519 (331%)

Cash: $99 (63% of Medicare)

Ins. Median: $519 (331% 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 331% of the Medicare baseline (a markup of 231%). 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 Shield Bh Mcr Adv	$51 - $196	32%
Blue Shield Mcr Adv	$51 - $196	32%
Kaiser Mcr Adv	$51 - $196	32%
Tricare	$51 - $196	32%
Ah Employee Health Plan - All Plans	$56 - $354	36%
Cigna	$61 - $1,243	39%
Interplan-All Plans	$61 - $1,010	39%
Kaiser-All Other Plans	$61 - $1,274	39%
Blue Shield Epn-All Other Plans	$67 - $732	43%
Blue Shield Non-Epn	$71 - $721	45%
Western Growers-All Plans	$76 - $824	48%
Blue Cross Blue Shield	$104 - $1,119	66%
Phcs-All Plans	$111 - $855	71%
Medi-Cal	$148	94%
Health Management Network-All Plans	$171 - $1,321	109%
Three Rivers-All Plans	$181 - $1,399	115%
Aetna	$191 - $795	122%
UnitedHealthcare	$196 - $991	125%
Va Mcr - All Other Plans	$196	125%
Va Medi-Cal	$222	141%
Healthnet-All Plans	$352	224%
Blue Shield Behav Hlth	$500 - $699	319%
Choicecare-All Plans	$777 - $1,088	495%
Beech Street-All Plans	$832 - $1,166	530%
Galaxy Network-All Plans	$999 - $1,399	636%

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 $99.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77066.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health St Helena is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77066.
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.