CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Loma Linda University Children's Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $370
Cash Discount Price: $269
vs. Medicare Baseline: 2.93x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Loma Linda University Children's Hospital is $370. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $269. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.93x the Medicare baseline. Located in 11234 Anderson Street Suite A, Loma Linda, CA.

Cash / Self-Pay

$269

Average discount available for prompt cash payment at this facility.

Insurance Median

$370

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: $269 (213%)

Insurance Median: $370 (293%)

Cash: $269 (213% of Medicare)

Ins. Median: $370 (293% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 293% of the Medicare baseline (a markup of 193%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Adventist Health	$120	95%
Lluh Dept Of Risk Management	$144	114%
Inland Empire Health Plan (Iehp)	$201	159%
Kaiser Foundation Hospitals	$227 - $399	180%
Epic Health Plan	$239	189%
Blue Shield Of California	$242 - $366	192%
UnitedHealthcare	$269	213%
Alpha Care Medical Group	$329 - $508	261%
Global Benefits Group	$359	284%
Temecula Valley Physicians Medical Group	$359	284%
Trivalley Medical Group	$359	284%
Blue Cross Blue Shield	$367	291%
Cigna	$383 - $443	303%
Networks By Design	$389	308%
Aetna	$392	310%
Molina Healthcare Of Ca	$419	332%
Multiplan	$478	379%
Dignity Health	$508	402%
Galaxy Health	$508	402%
Prime Health Services	$508	402%
Vantage Medical Group	$508	402%

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 $269.
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 Loma Linda University Children's Hospital 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.