CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Adventist Health Ukiah Valley

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $536
  • Cash Discount Price: $118
  • vs. Medicare Baseline: 4.25x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Adventist Health Ukiah Valley is $536. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $118. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 4.25x the Medicare baseline. Located in 275 Hospital Drive, Ukiah, CA.
Cash / Self-Pay
$118

Average discount available for prompt cash payment at this facility.

Insurance Median
$536

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: $118 (93%)
Insurance Median: $536 (425%)
Cash: $118 (93% of Medicare)
Ins. Median: $536 (425% 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 425% of the Medicare baseline (a markup of 325%). 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
Blue Shield Mcr Adv $36 - $135 29%
Kaiser Mcr Adv $36 - $135 29%
Tricare $36 - $135 29%
Ah Employee Health Plan - All Plans $39 - $244 31%
Mendocino Lcc District-All Plans $46 - $903 36%
Cigna $47 - $1,083 37%
UnitedHealthcare $48 - $1,161 38%
Blue Shield Epn-All Other Plans $50 - $529 40%
Healthnet-All Plans $52 - $795 41%
Blue Shield Non-Epn $53 - $536 42%
Western Growers-All Plans $53 - $583 42%
Kaiser-All Other Plans $57 - $1,111 45%
Three Rivers-All Plans $64 - $1,250 51%
Kaiser Medi-Cal $71 - $180 56%
Medi-Cal $71 - $180 56%
Aetna $92 - $693 73%
Blue Cross Blue Shield $780 - $1,041 618%
Foundation For Medical Care-All Plans $782 - $1,042 619%
Networks By Design-All Plans $834 - $1,111 661%
Phcs Multiplan-All Plans $834 - $1,111 661%
Interplan-All Plans $854 - $1,139 676%
Beech Street-All Plans $886 - $1,181 702%
Choice Care-All Plans $886 - $1,181 702%
Health Mgmt Network-All Plans $886 - $1,181 702%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 275 Hospital Drive, Ukiah, CA 95482
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals