CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Riverside Community Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $118
Cash Discount Price: $1,300
vs. Medicare Baseline: 0.93x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Riverside Community Hospital is $118. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,300. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.93x the Medicare baseline. Located in 4445 Magnolia Avenue, Riverside, CA.

Cash / Self-Pay

$1,300

Average discount available for prompt cash payment at this facility.

Insurance Median

$118

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: $1,300 (1030%)

Insurance Median: $118 (93%)

Cash: $1,300 (1030% of Medicare)

Ins. Median: $118 (93% 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.

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
Bristol Hospice	$80	63%
La Care Health	$88	70%
Molina	$88	70%
Blue Shield	$93 - $721	74%
Brand New Day	$97 - $100	77%
Health Net	$98	78%
Aetna	$99 - $234	78%
Alignment Health Plan	$100	79%
Blue Cross Blue Shield	$100 - $689	79%
Central Health Plan	$100	79%
Clever Care Of Golden State	$100	79%
Easy Choice Health Plan	$100	79%
Heritage Provider Network	$100 - $137	79%
Humana	$100	79%
Redlands Community Hospital	$100	79%
Riverside Medical Clinic	$100 - $120	79%
Riverside Physician	$100	79%
Scan Health Plan	$100	79%
Triwest Healthcare Alliance	$100	79%
UnitedHealthcare	$100	79%
Care1St Health Plan	$102	81%
United	$102 - $342	81%
Corvel Corporation	$116	92%
Healthsmart	$118 - $1,040	93%
Next	$118 - $1,040	93%
Inland Empire Health Plan	$128 - $170	101%
Medcare Partners	$195	154%
Cigna	$339	269%
Redlands Community	$390	309%
First Health	$572 - $1,170	453%
American Health System	$585	463%
Multiplan	$1,040 - $1,105	824%

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 $1,300.
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 Riverside Community Hospital 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.