CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Memorialcare Orange Coast Medical Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $187
Cash Discount Price: $1,170
vs. Medicare Baseline: 1.48x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Memorialcare Orange Coast Medical Center is $187. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,170. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.48x the Medicare baseline. Located in 9920 Talbert Avenue, Fountain Valley, CA.

Cash / Self-Pay

$1,170

Average discount available for prompt cash payment at this facility.

Insurance Median

$187

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: $1,170 (927%)

Insurance Median: $187 (148%)

Cash: $1,170 (927% of Medicare)

Ins. Median: $187 (148% 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
Seoul Medical Group	$98	78%
Blue Shield	$107 - $1,176	85%
Blue Cross Blue Shield	$109 - $297	86%
Molina	$112	89%
Universal Care	$114	90%
Central Health	$120	95%
UnitedHealthcare	$120	95%
Clever Care	$131	104%
Healthcare Partners	$136 - $296	108%
Select Health	$147	116%
Monarch Health Plan	$175 - $272	139%
Centivo	$245	194%
Cigna	$266 - $394	211%

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 $1,170.
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 Memorialcare Orange Coast Medical Center 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.