CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Casa Colina Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $163
  • Cash Discount Price: $188
  • vs. Medicare Baseline: 1.29x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Casa Colina Hospital is $163. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $188. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.29x the Medicare baseline. Located in 255 E Bonita Ave, Pomona, CA.
Cash / Self-Pay
$188

Average discount available for prompt cash payment at this facility.

Insurance Median
$163

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: $188 (149%)
Insurance Median: $163 (129%)
Cash: $188 (149% of Medicare)
Ins. Median: $163 (129% 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.

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
Heritage Prvdr Ntwrk Mcal $116 92%
Heritage Prvdr Ntwrk Comm - All Other Plans $130 - $141 103%
Heritage Prvdr Ntwrk Mcr $130 - $141 103%
Prospect Hp Mcal $130 103%
Healthnet Comm - All Other Plans $133 - $144 105%
Promed Hlth Ntwrk Op Only - All Plans $138 109%
Aetna $145 - $176 115%
Blue Cross Blue Shield $145 - $206 115%
Blue Shield Mcr Adv $145 115%
Caremore Mcr Adv - All Plans $145 115%
Central Hlth Plan - All Plans $145 115%
Doctors Managed Op Only - All Plans $145 115%
Empire Healthcare Op Only - All Plans $145 115%
Epic Comm - All Other Plans $145 115%
Epic Mcr Adv $145 115%
Focus Healthcare Wc - All Plans $145 115%
Healthnet Mcr Adv $145 115%
Humana $145 - $176 115%
Iehp - All Other Plans $145 115%
Iehp Mcr Adv $145 115%
Kaiser Comm - All Other Plans $145 115%
Kaiser Mcr Adv $145 115%
Premiercare Op Only - All Plans $145 115%
Prospect Hp Mcr Adv $145 115%
Triwest - All Plans $145 115%
UnitedHealthcare $145 - $176 115%
Wellcare Mcr Adv - All Plans $145 115%
Prospect Hp Comm - All Other Plans $159 126%
Corvel - All Plans $163 - $176 129%
Coventry - All Plans $163 - $176 129%
Multiplan - All Plans $163 - $176 129%
Three Rivers - All Plans $163 - $176 129%
Medi-Cal $180 143%
Affiliated Hlth Funds - All Plans $181 143%
Brand New Day Mcr Adv - All Plans $195 - $211 154%
Kaiser Mcal $198 157%
Galaxy Provdr Ntwrk - All Plans $228 - $246 181%
Blue Shield Comm - All Other Plans $240 - $260 190%
Cigna $255 202%
Healthcare Partners - All Other Plans $260 - $282 206%
Healthcare Partners Mcr $260 - $282 206%
Primecare Comm - All Other Plans $260 - $282 206%
Primecare Mcr Adv $260 - $282 206%
Prospect Med Grp Alta - All Plans $276 - $299 219%
Iehp Mcal $325 - $352 257%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 255 E Bonita Ave, Pomona, CA 91767
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals