CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Adventist Health Ukiah Valley

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $222
Cash Discount Price: $127
vs. Medicare Baseline: 1.41x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Adventist Health Ukiah Valley is $222. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $127. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.41x the Medicare baseline. Located in 275 Hospital Drive, Ukiah, CA.

Cash / Self-Pay

$127

Average discount available for prompt cash payment at this facility.

Insurance Median

$222

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$156.98

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $156.98 (100%)

Cash / Self-Pay: $127 (81%)

Insurance Median: $222 (141%)

Cash: $127 (81% of Medicare)

Ins. Median: $222 (141% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $156.98 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 Mcr Adv	$47 - $168	30%
Kaiser Mcr Adv	$47 - $168	30%
Tricare	$47 - $168	30%
Ah Employee Health Plan - All Plans	$52 - $302	33%
Cigna	$61 - $843	39%
UnitedHealthcare	$62 - $904	39%
Blue Shield Epn-All Other Plans	$63 - $412	40%
Blue Shield Non-Epn	$66 - $417	42%
Healthnet-All Plans	$69 - $618	44%
Western Growers-All Plans	$70 - $454	45%
Aetna	$111 - $840	71%
Mendocino Lcc District-All Plans	$120 - $703	76%
Kaiser Medi-Cal	$148 - $222	94%
Kaiser-All Other Plans	$148 - $865	94%
Medi-Cal	$148 - $222	94%
Three Rivers-All Plans	$166 - $973	106%
Foundation For Medical Care-All Plans	$811	517%
Networks By Design-All Plans	$865	551%
Phcs Multiplan-All Plans	$865	551%
Interplan-All Plans	$886	564%
Beech Street-All Plans	$919	585%
Choice Care-All Plans	$919	585%
Health Mgmt Network-All Plans	$919	585%
Blue Cross Blue Shield	$945 - $1,260	602%

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 $127.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77066.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health Ukiah Valley is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77066.
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.