CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Good Samaritan Hospital

Billing Code: 77067 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$129
about 1.0× the $126 Medicare rate · typically $81–$234
modeled estimate · not a bill or quote
What this hospital charges insurers
$134
About the fair price
about $5 over the fair price · 1.1× Medicare
Medicare pays $126 Fair price $129 This hospital $134 Cash price $2,220 Hospital's list price $2,220

How we calculate the fair BaseRate →

How this hospital compares to other CA hospitals

Highest price of the 9 CA hospitals we have prices for — worth calling around.

Cheapest $36 Priciest $134

Black dot = this hospital, among the 9 CA hospitals with a price for this procedure. Full list below.

⚠ The cash price looks unusually high next to the insurance price — it may be the full list price, not a real cash discount. Call to confirm the self-pay rate.

A fair price for a Screening mammogram (both breasts) is about $129 (about 1.0× the $126 Medicare rate). Good Samaritan Hospital charges insurers about $134, or about $2,220 in cash — about the fair price. Located in San Jose, CA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $134 - $668 106%
Blue Cross Blue Shieldmajor $97 - $1,119 77%
Aetnamajor $131 - $5,074 104%
Cignamajor $128 - $2,096 101%
Humanamajor $131 - $1,834 104%
Health Net $128 - $1,572 101%
+ 19 smaller / regional plans $84 - $2,096
Government programs also on file: Military & VA.
Excludes 5 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

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Facility Profile & Credentials

  • Address: 2425 Samaritan Drive, San Jose, CA 95124
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals