CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Montclair Hospital Medical Center

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $121
  • Cash Discount Price: $121
  • vs. Medicare Baseline: 0.77x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Montclair Hospital Medical Center is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $121. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 0.77x the Medicare baseline. Located in 5000 San Bernardino Road, Montclair, CA.
Cash / Self-Pay
$121

Average discount available for prompt cash payment at this facility.

Insurance Median
$121

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: $121 (77%)
Insurance Median: $121 (77%)
Cash: $121 (77% of Medicare)
Ins. Median: $121 (77% 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.

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 Of Promise $108 69%
Molina $108 - $121 69%
Traditional Medi-Cal $108 69%
Vantage Care $108 - $121 69%
Rios $115 73%
Health Net Of Ca $116 - $177 74%
Alignment $121 77%
Central Health Plan $121 77%
Choice Physicians Network $121 77%
Citrus Valley Physicians Group $121 77%
Elite Health Plan $121 77%
Emanate Health $121 - $242 77%
Epic Health Plan $121 77%
Inland Empire Foundation For Medical Care $121 77%
Inland Empire Healthplan $121 - $157 77%
Medicare (plans) $121 77%
Renal Payor Solution $121 77%
Tricare $121 77%
Brand New Day $122 - $182 78%
Neighborhood $123 78%
Imperial Health Plan Of Ca $128 82%
Health Net Federal Services Prison (Cdcr) $151 96%
Blue Cross Blue Shield $155 99%
Coventry Workers Compensation $155 99%
Worker Compensation $159 101%
Employer Direct Health Care $169 108%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 5000 San Bernardino Road, Montclair, CA 91763
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals