CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Adventist Health St Helena

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $552
  • Cash Discount Price: $145
  • vs. Medicare Baseline: 4.37x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Adventist Health St Helena is $552. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $145. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 4.37x the Medicare baseline. Located in 10 Woodland Road, Saint Helena, CA.
Cash / Self-Pay
$145

Average discount available for prompt cash payment at this facility.

Insurance Median
$552

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: $145 (115%)
Insurance Median: $552 (437%)
Cash: $145 (115% of Medicare)
Ins. Median: $552 (437% 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 437% of the Medicare baseline (a markup of 337%). 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
Blue Shield Bh Mcr Adv $39 - $159 31%
Blue Shield Mcr Adv $39 - $159 31%
Kaiser Mcr Adv $39 - $159 31%
Tricare $39 - $159 31%
Ah Employee Health Plan - All Plans $43 - $286 34%
Cigna $47 - $1,234 37%
Interplan-All Plans $47 - $1,003 37%
Kaiser-All Other Plans $47 - $1,265 37%
Blue Shield Epn-All Other Plans $54 - $727 43%
Blue Shield Non-Epn $57 - $716 45%
Western Growers-All Plans $57 - $818 45%
Phcs-All Plans $65 - $849 51%
Blue Cross Blue Shield $79 - $924 63%
Health Management Network-All Plans $100 - $1,312 79%
Three Rivers-All Plans $106 - $1,389 84%
Medi-Cal $118 - $119 93%
Aetna $158 - $656 125%
UnitedHealthcare $159 - $984 126%
Va Mcr - All Other Plans $159 126%
Va Medi-Cal $180 143%
Healthnet-All Plans $352 279%
Blue Shield Behav Hlth $372 - $694 295%
Choicecare-All Plans $579 - $1,080 459%
Beech Street-All Plans $620 - $1,157 491%
Galaxy Network-All Plans $744 - $1,389 589%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 10 Woodland Road, Saint Helena, CA 94574
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals