CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Grossmont Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $319
Cash Discount Price: $435
vs. Medicare Baseline: 2.53x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Grossmont Hospital is $319. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $435. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.53x the Medicare baseline. Located in 5555 Grossmont Center Drive Box 58, La Mesa, CA.

Cash / Self-Pay

$435

Average discount available for prompt cash payment at this facility.

Insurance Median

$319

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: $435 (345%)

Insurance Median: $319 (253%)

Cash: $435 (345% of Medicare)

Ins. Median: $319 (253% 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 253% of the Medicare baseline (a markup of 153%). 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
Molina	$13 - $328	10%
Aetna	$37 - $464	29%
Health Net	$37 - $476	29%
California Health And Wellness	$81 - $172	64%
Cigna	$87 - $406	69%
Blue Cross Blue Shield	$172	136%
UnitedHealthcare	$172 - $464	136%
Multiplan	$197 - $626	156%
Indian Health Council	$290	230%
Interplan	$319	253%
Blue Shield	$328	260%
Kaiser	$370	293%
Humana	$389	308%
Community Health Group	$400 - $435	317%
County Medical Services	$406	322%
Managed Health Network	$406	322%

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 $435.
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 Grossmont 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.