CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Oak Valley Hospital District

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $137
Cash Discount Price: $152
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Oak Valley Hospital District is $137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $152. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.09x the Medicare baseline. Located in 350 S Oak Ave, Oakdale, CA.

Cash / Self-Pay

$152

Average discount available for prompt cash payment at this facility.

Insurance Median

$137

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: $152 (120%)

Insurance Median: $137 (109%)

Cash: $152 (120% of Medicare)

Ins. Median: $137 (109% 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
Blue Shield Epn Ip/Op Only	$36 - $434	29%
Healthnet Comm Op Only Ip/Op Only-All Other Plans	$38 - $466	30%
Kaiser Comm Ip/Op Only-All Other Plans	$41 - $498	32%
Blue Cross Blue Shield	$43 - $723	34%
Blue Shield/Bcout Ip/Op Only-All Other Plans	$44 - $530	35%
Cigna	$44 - $538	35%
UnitedHealthcare	$46 - $562	36%
Aetna	$56 - $683	44%
Healthnet Medi-Cal Ip/Op Only	$66 - $180	52%
Hp Of San Joaquin Ip/Op Only-All Plans	$66 - $216	52%
Kaiser Medi-Cal Ip/Op Only	$66 - $180	52%
Medi-Cal Ip/Op Only	$66 - $180	52%
Alignment Op Only Ip/Op Only-All Plans	$135	107%
Humana	$135	107%
Kaiser Mcr Adv Ip/Op Only	$135	107%
Scan Health Plan Ip/Op Only-All Plans	$138	109%
Imperial Health Ip/Op Only-All Plans	$149	118%

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 $152.
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 Oak Valley Hospital District 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.