CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Adventist Health White Memorial Montebello

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $222
Cash Discount Price: $178
vs. Medicare Baseline: 1.41x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Adventist Health White Memorial Montebello is $222. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $178. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.41x the Medicare baseline. Located in 309 W Beverly Blvd, Montebello, CA.

Cash / Self-Pay

$178

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: $178 (113%)

Insurance Median: $222 (141%)

Cash: $178 (113% 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 Epn Ifp	$177 - $198	113%
Aetna	$178 - $418	113%
Alignment Health Plan-All Plans	$178	113%
Altamed Mcare-All Other Plans	$178	113%
Blue Shield Mcare Adv	$178	113%
Brand New Day Mcare-All Other Plans	$178	113%
Brandman Health Plan-All Plans	$178	113%
Caremore-All Plans	$178	113%
Clever Care Hp-All Plans	$178	113%
Easy Choice Mcare Adv-All Plans	$178	113%
Healthnet Med Adv	$178	113%
Kaiser Mcare Adv	$178	113%
Scan Health-All Plans	$178	113%
Oscar-All Plans	$186	118%
Altamed Mcal	$222	141%
Bc Mcal	$222	141%
Blue Shield Promise Mcal	$222	141%
Brand New Day Mcal	$222	141%
Healthnet Mcal	$222	141%
Kaiser Mcal	$222	141%
La Care Mcal	$222	141%
Medi-Cal	$222	141%
Molina Mcal - All Plans	$222	141%
Blue Shield Epn Core	$271	173%
Blue Shield Comm - All Other Plans	$281	179%
Healthnet Salud	$303 - $339	193%
Cigna	$329	210%
Healthnet Comm-All Other Plans	$365 - $409	233%
Healthcare Partners-All Plans	$499 - $559	318%
Blue Cross Blue Shield	$676 - $757	431%

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 $178.
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 White Memorial Montebello 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.