CMS Price Transparency Data
Screening mammogram (both breasts)
Facility: Adventist Health White Memorial
Billing Code: 77067 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 77067
- Insurance Median: $405
- Cash Discount Price: $247
- vs. Medicare Baseline: 3.21x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Adventist Health White Memorial is $405. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $247. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 3.21x the Medicare baseline. Located in 1720 Cesar E Chavez Avenue, Los Angeles, CA.
Cash / Self-Pay
$247
Average discount available for prompt cash payment at this facility.
Insurance Median
$405
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: $247 (196%)
Insurance Median: $405 (321%)
Cash: $247 (196% of Medicare)
Ins. Median: $405 (321% 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 321% of the Medicare baseline (a markup of 221%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
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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 |
|---|---|---|
| Bc Medi-Cal | $40 | 32% |
| Blue Shield Mcr Adv | $85 | 67% |
| Access Group | $123 | 97% |
| Ahp - All Other Plans | $123 | 97% |
| Lasalle Mg Commercial - All Other Plans | $123 | 97% |
| UnitedHealthcare | $125 - $754 | 99% |
| Access Senior - All Other Plans | $145 | 115% |
| Ahp Senior | $145 | 115% |
| Alta Los Angeles Mcr 1/1/19-All Other Plans | $145 | 115% |
| Altamed Connect | $145 | 115% |
| Avanti Mcr Adv - All Other Plans | $145 | 115% |
| Brand New Day Mcare - All Plans | $145 | 115% |
| Bs Va Mcare | $145 | 115% |
| Care First Mcare - All Other Plans | $145 | 115% |
| Clever Care - All Plans | $145 | 115% |
| Fcs Ipa Mcr Advan Op/Profee Only | $145 | 115% |
| Humana | $145 | 115% |
| Lasalle Mg Senior | $145 | 115% |
| Medicare (plans) | $145 | 115% |
| Molina Mcare | $145 | 115% |
| Pacific Alliance Mcare - All Other Plans | $145 | 115% |
| Preferred Senior | $145 | 115% |
| Sunlight Living Hlth Mcr Adv-All Other Plans | $145 | 115% |
| Tricare | $145 | 115% |
| Blue Cross Blue Shield | $151 - $930 | 120% |
| Fcs Ipa Op/Profee Only - All Other Plans | $152 | 120% |
| Bright Health - All Plans | $167 | 132% |
| Assoc Hispanic Physcns Hmo/Mcr Adv-All Other Plans | $174 | 138% |
| Preferred Commercial - All Other Plans | $174 | 138% |
| Access Medi-Cal | $180 | 143% |
| Ahp Medi-Cal | $180 | 143% |
| Alta Los Angeles Mcal 1/1/19 | $180 | 143% |
| Avanti Mcal | $180 | 143% |
| Bella Vista Medi-Cal Op/Profee Only | $180 | 143% |
| Healthcare Inc Medi-Cal | $180 | 143% |
| Lasalle Mg Medi-Cal | $180 | 143% |
| Medi-Cal | $180 | 143% |
| Molina Medi-Cal | $180 | 143% |
| Pacific Alliance Medi-Cal | $180 | 143% |
| Pacific Ipa Medi-Cal | $180 | 143% |
| Preferred Ipa La Care Mcal Cap | $180 | 143% |
| Preferred Medi-Cal | $180 | 143% |
| Intergrated Medical - All Plans | $188 | 149% |
| Molina Benefit Exchange - All Other Plans | $196 | 155% |
| Altamed Medi-Cal - All Other Plans | $207 | 164% |
| Healthnet Mcal | $214 | 170% |
| Fcs Ipa Medi-Cal Op/Profee Only | $216 | 171% |
| Php-Prospect Health Plan Cap - All Plans | $217 | 172% |
| Preferred Healthy | $225 | 178% |
| Assoc Hispanic Physcns Mcal | $252 | 200% |
| Ah Employee Health Plan - All Plans | $261 | 207% |
| Blue Shield Epn | $280 - $374 | 222% |
| Blue Shield - All Other Plans | $326 - $435 | 258% |
| Centivo - All Plans | $326 | 258% |
| Aetna | $440 | 349% |
| Pacific Ipa - All Other Plans | $448 - $597 | 355% |
| Blue Shield Medi-Cal | $449 | 356% |
| Kaiser- All Plans | $483 - $644 | 383% |
| Western Growers/Pinnacle - All Plans | $483 - $644 | 383% |
| Healthnet - All Other Plans | $533 - $710 | 422% |
| Healthnet Comm Care | $550 - $733 | 436% |
| Caremore Mcare - All Plans | $589 - $786 | 467% |
| Hcpamg - All Plans | $590 - $787 | 467% |
| Cigna | $622 | 493% |
| Care First Medi-Cal | $629 | 498% |
| Healthcare Inc - All Other Plans | $648 - $864 | 513% |
| La Care Mcr Adv - All Plans | $648 - $864 | 513% |
| First Heatlh Ppo - All Plans | $683 - $911 | 541% |
| Phcs Ppo - All Plans | $766 - $1,021 | 607% |
| Scan Health Mcare - All Plans | $766 - $1,021 | 607% |
| Ahf - All Plans | $884 - $1,178 | 700% |
| Beech Street - All Plans | $884 - $1,178 | 700% |
| Interplan Ppo - All Plans | $884 - $1,178 | 700% |
| Corvel Corp - All Plans | $942 - $1,257 | 746% |
| Multiplan Ppo - All Plans | $978 - $1,304 | 775% |
| Healthmannet - All Plans | $1,001 - $1,335 | 793% |
| Next Inc Ppo - All Plans | $1,001 - $1,335 | 793% |
| Trpn - All Plans | $1,001 - $1,335 | 793% |
| Bella Vista Mcr Adv Op/Profee Only - All Other Pla | $1,060 - $1,414 | 840% |
| Fpn Ppo - All Plans | $1,060 - $1,414 | 840% |
| Healthnet Mcr Adv | $1,802 - $2,404 | 1427% |