CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: City of Hope National Medical Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $342
Cash Discount Price: $428
vs. Medicare Baseline: 2.71x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at City of Hope National Medical Center is $342. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $428. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.71x the Medicare baseline. Located in 1500 Duarte Rd, Duarte, CA.

Cash / Self-Pay

$428

Average discount available for prompt cash payment at this facility.

Insurance Median

$342

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: $428 (339%)

Insurance Median: $342 (271%)

Cash: $428 (339% of Medicare)

Ins. Median: $342 (271% 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 271% of the Medicare baseline (a markup of 171%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Health Net	$62 - $415	49%
Cal Optima	$86 - $117	68%
Heritage Provider Network	$110 - $299	87%
Inland Empire	$133 - $342	105%
Prime Healthcare Keenan	$187 - $410	148%
Blue Cross Blue Shield	$214 - $834	170%
UnitedHealthcare	$239 - $398	189%
Blue Shield	$253 - $510	200%
Blue Shield Covca	$260	206%
Blue Shield Promise	$299	237%
Cencal	$342	271%
La Care Health	$342	271%
Kaiser	$385	305%
Aetna	$428	339%
Gold Coast	$428	339%
Molina	$428 - $556	339%
Facey	$470	372%
Healthcare Partners	$496	393%
Cigna	$508	402%
St. Joseph Heritage	$513	406%
Primecare Medical Network	$556	440%
First Health	$658	521%
Phcs Multiplan	$770	610%

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 $428.
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 City of Hope National Medical Center 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.