CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Adventist Health Lodi Memorial

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $64
Cash Discount Price: $13
vs. Medicare Baseline: 0.41x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Adventist Health Lodi Memorial is $64. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $13. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 0.41x the Medicare baseline. Located in 975 S Fairmont Avenue, Lodi, CA.

Cash / Self-Pay

$13

Average discount available for prompt cash payment at this facility.

Insurance Median

$64

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: $13 (8%)

Insurance Median: $64 (41%)

Cash: $13 (8% of Medicare)

Ins. Median: $64 (41% 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
Alignment Health Plan (Ahp)-All Plans	$47	30%
Blue Shield Mcare Adv	$47	30%
Healthnet Mcare	$47	30%
Hp Of San Joaquin Mcr Adv	$47	30%
Humana	$47	30%
Knnex Health - All Plans	$47	30%
Tricare	$47	30%
UnitedHealthcare	$47 - $217	30%
Hp Healthy Kids Pro Fee	$50	32%
Ah Employee Health Plan - All Plans	$52	33%
Cigna	$56	36%
First Health- All Plans	$57	36%
Beech Street- All Plans	$61	39%
Hp Of San Joaquin Ppo - All Other Plans	$61	39%
Multiplan- All Plans	$61	39%
Blue Shield Epn - All Other Plans	$63	40%
Kaiser Commercial - All Other Plans	$64	41%
Kaiser Mcr Adv	$64	41%
Networks By Design- All Plans	$64	41%
Blue Shield Non-Epn	$66	42%
Healthnet- All Other Plans	$69	44%
Western Growers- All Plans	$72	46%
Blue Cross Blue Shield	$98	62%
Bc Mcal	$148	94%
Celtic Ins Company - All Plans	$148	94%
Kaiser Mcal	$148	94%
Medi-Cal	$148	94%
Hp Mcal Pro Fee	$163	104%
Aetna	$168	107%
Healthnet Mcal	$178	113%
Hp Of San Joaquin Mcal	$178	113%

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 $13.
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 Lodi Memorial 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.