CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Adventist Health White Memorial Montebello

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $180
Cash Discount Price: $144
vs. Medicare Baseline: 1.43x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Adventist Health White Memorial Montebello is $180. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $144. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.43x the Medicare baseline. Located in 309 W Beverly Blvd, Montebello, CA.

Cash / Self-Pay

$144

Average discount available for prompt cash payment at this facility.

Insurance Median

$180

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: $144 (114%)

Insurance Median: $180 (143%)

Cash: $144 (114% of Medicare)

Ins. Median: $180 (143% 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.

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	$51 - $149	40%
Healthnet Salud	$87 - $256	69%
Healthnet Comm-All Other Plans	$104 - $308	82%
Aetna	$107 - $315	85%
Healthcare Partners-All Plans	$143 - $421	113%
Alignment Health Plan-All Plans	$144	114%
Altamed Mcare-All Other Plans	$144	114%
Blue Shield Mcare Adv	$144	114%
Brand New Day Mcare-All Other Plans	$144	114%
Brandman Health Plan-All Plans	$144	114%
Caremore-All Plans	$144	114%
Clever Care Hp-All Plans	$144	114%
Easy Choice Mcare Adv-All Plans	$144	114%
Healthnet Med Adv	$144	114%
Kaiser Mcare Adv	$144	114%
Scan Health-All Plans	$144	114%
Oscar-All Plans	$151	120%
Altamed Mcal	$180	143%
Bc Mcal	$180	143%
Blue Shield Promise Mcal	$180	143%
Brand New Day Mcal	$180	143%
Healthnet Mcal	$180	143%
Kaiser Mcal	$180	143%
La Care Mcal	$180	143%
Medi-Cal	$180	143%
Molina Mcal - All Plans	$180	143%
Blue Cross Blue Shield	$193 - $570	153%
Cigna	$267	211%
Blue Shield Epn Core	$271	215%
Blue Shield Comm - All Other Plans	$281	223%

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 $144.
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 Adventist Health White Memorial Montebello 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.