CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: San Antonio Regional Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $575
  • Cash Discount Price: $187
  • vs. Medicare Baseline: 4.55x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at San Antonio Regional Hospital is $575. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $187. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 4.55x the Medicare baseline. Located in 999 San Bernardino Road, Upland, CA.
Cash / Self-Pay
$187

Average discount available for prompt cash payment at this facility.

Insurance Median
$575

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: $187 (148%)
Insurance Median: $575 (455%)
Cash: $187 (148% of Medicare)
Ins. Median: $575 (455% 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 455% of the Medicare baseline (a markup of 355%). 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.

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
Tricare $133 105%
Blue Shield Mcr Adv $136 108%
Caremore Mcr Adv - All Plans $136 108%
Choice Phycn Ntwrk Mcr Adv-All Other Plans $136 108%
Healthnet Mcr Adv $136 108%
Humana $136 108%
Iehp Mcr Adv $136 108%
Inter Valley Hp Mcr Adv- All Plans $136 108%
Kindred Mcr Adv-All Plans $136 108%
Molina Mcr Adv $136 108%
Scan Health Plan Mcr Adv-All Plans $136 108%
Universal Care - All Plans $136 108%
Blue Cross Blue Shield $139 - $822 110%
Zelis Mcr Adv $143 113%
Kasiser Mcr Adv $146 116%
Imperial Health Mcr Adv-All Plans $150 119%
Choice Phycn Ntwrk Op Only $170 135%
Blue Shield Epn $172 - $246 136%
Molina Exchange-All Other Plans $177 140%
Medi-Cal $180 143%
UnitedHealthcare $182 - $575 144%
Aetna $184 - $1,512 146%
Kaiser Medi-Cal $189 150%
Healthnet Medi-Cal $190 150%
Ambetter / Centene $193 - $275 153%
Iehp Comm - All Other Plans $197 156%
Alpha Care Mg Mcal/Hlthy Kids $198 157%
Heritage Prov Ntwrk/Regal Mcal $198 157%
Redlands Employee $204 162%
Molina Medi-Cal $207 164%
Redlands Hmo-All Other Plans $212 168%
Iehp Mcal $234 185%
Prime Health - All Plans $238 189%
Epic Health Plan - All Other Plans $317 - $454 251%
Healthnet - All Other Plans $326 258%
Kaiser Comm - All Other Plans $380 301%
Blue Shield Hmo Pos / Calpers Ppo $382 - $546 303%
Blue Shield Epo Ppo - All Other Plans $410 - $587 325%
Pc Inland Valley Scan $529 - $756 419%
Pc Inland Valley-All Other Plans $529 - $756 419%
Cigna $576 456%
Coventry Ccn/First Hlth - All Plans $582 - $832 461%
Choicecare Ntwrk-All Plans $762 - $1,089 604%
Multiplan/Phcs - All Plans $762 - $1,089 604%
Networks By Design - All Plans $794 - $1,134 629%
Zelis Comm-All Other Plans $794 - $1,134 629%
Foundation Inland Epo-All Other Plans $846 - $1,210 670%
Foundation Inland Ppo $899 - $1,285 712%
Health Payors - All Plans $952 - $1,361 754%
Interplan - All Plans $952 - $1,361 754%
Wellcare/Easy Choice-All Plans $1,037 - $1,482 821%
Alpha Care Mg Mcr Adv $1,058 - $1,512 838%
Central Hlth Plan Mcr Adv-All Plans $1,058 - $1,512 838%
Epic Health Plan Mcr Adv $1,058 - $1,512 838%
Prospect Hp-All Plans $1,058 - $1,512 838%
Providence Clevercare Mcr Adv $1,058 - $1,512 838%
Heritage Prov Ntwrk/Regal Mcr Adv $1,074 - $1,535 851%
Clever Care Mcr Adv - All Plans $1,111 - $1,588 880%
La Salle Hp Mcr Adv-All Plans $1,111 - $1,588 880%
Providence Oscar-All Other Plans $1,111 - $1,588 880%
Alpha Care Mg-All Other Plans $1,322 - $1,890 1047%
Heritage Prov Ntwrk/Regal - All Other Plans $1,944 - $2,778 1540%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 999 San Bernardino Road, Upland, CA 91786
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals