CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Sonoma Valley Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $336
  • Cash Discount Price: $463
  • vs. Medicare Baseline: 2.66x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Sonoma Valley Hospital is $336. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $463. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.66x the Medicare baseline. Located in 347 Andrieux St, Sonoma, CA.
Cash / Self-Pay
$463

Average discount available for prompt cash payment at this facility.

Insurance Median
$336

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: $463 (367%)
Insurance Median: $336 (266%)
Cash: $463 (367% of Medicare)
Ins. Median: $336 (266% 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 266% of the Medicare baseline (a markup of 166%). 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.

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Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Meritage Medical Network Op Only Mcare $37 29%
Meritage Medical Network Op Only-All Other Plans $47 37%
Aetna $115 91%
First Health(Coventry)-All Plans $115 91%
Tricare $146 116%
Blue Cross Blue Shield $149 - $434 118%
Bright Hlth/Brand New Day Mcr Adv $149 118%
Hospice Of Marin-All Plans $149 118%
St Joseph Heritage Hltcare Comm-All Other Plans $149 118%
Veterans Admin-All Plans $149 118%
Marin General Comm/Mcr Adv (Western Hlth)-All Plan $156 124%
Cdcr Prison-All Plans $179 142%
Three Rivers (Trpn)-All Plans $179 142%
Medi-Cal $180 143%
Chp - Correctional Health Partners - All Plans $194 154%
Bright Hlth/Brand New Day - All Other Plands $201 159%
Wellpath - All Plans $209 166%
Healthnet Hmo/Ppo-All Other Plans $231 183%
UnitedHealthcare $245 194%
Canopy Bay Area Accountable Care Ntwrk (Baacn) - A $268 212%
Canopy Health Solutions-All Other Plans $268 212%
Mcal Mgd Care (Php)-All Plans $297 235%
Blue Shield Ppo-All Plans $375 297%
Kaiser-All Plans $430 341%
Integrated Health Plan-All Plans $489 387%
Champus-All Plans $529 419%
Cigna $529 419%
Networks By Design - All Plans $529 419%
Comm Care Network(Ccn)-All Plans $562 445%
Great West-One Health Plan Ppo/Pos-All Plans $562 445%
Phcs/Multiplan/Beech St-All Plans $562 445%
Interplan-All Plans $582 461%
Bps-All Plans $595 471%
Ppo Alliance-All Plans $595 471%
Pref Health Networl(Phn)-All Plans $595 471%
Partnership Healthplan-All Plans $629 498%
Scan Mcare-All Plans $661 524%
St Joseph Heritage Hltcare Mcr Adv $661 524%
Correct Care Integ Health-All Plans $793 628%
Employer Direct Healthcare-All Plans $793 628%
Creative Legal Services-All Plans $859 680%
Canopy Op Only $1,190 943%
Vnpn - All Plans $1,190 943%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 347 Andrieux St, Sonoma, CA 95476
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Government - Hospital District or Authority
  • Hospital Type: Acute Care Hospitals