CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: San Gorgonio Memorial Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $36
Cash Discount Price: $105
vs. Medicare Baseline: 0.29x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at San Gorgonio Memorial Hospital is $36. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $105. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.29x the Medicare baseline. Located in 600 North Highland Springs Avenue, Banning, CA.

Cash / Self-Pay

$105

Average discount available for prompt cash payment at this facility.

Insurance Median

$36

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: $105 (83%)

Insurance Median: $36 (29%)

Cash: $105 (83% of Medicare)

Ins. Median: $36 (29% 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
Lasalle Medical Associates	$34	27%
Beaver Medical Group	$36	29%
Blue Cross Blue Shield	$36 - $174	29%
Blue Shield	$36	29%
Choice Physicians Network	$36	29%
Heritage Provider Network	$36	29%
Inland Empire Health Plan	$36 - $40	29%
Kaiser	$36 - $109	29%
Providence Health Network	$36	29%
Redlands Community Hospital	$36 - $42	29%
UnitedHealthcare	$36	29%
Easy Choice Health Plan	$38	30%
Epic Management	$38	30%
Velocity	$40	32%
Imperial Health Plan	$41	32%
Health Net	$46 - $52	36%

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 $105.
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 San Gorgonio Memorial 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.