CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Adventist Health Tulare

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $168
Cash Discount Price: $108
vs. Medicare Baseline: 1.07x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Adventist Health Tulare is $168. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $108. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.07x the Medicare baseline. Located in 869 North Cherry Street, Tulare, CA.

Cash / Self-Pay

$108

Average discount available for prompt cash payment at this facility.

Insurance Median

$168

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: $108 (69%)

Insurance Median: $168 (107%)

Cash: $108 (69% of Medicare)

Ins. Median: $168 (107% 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.

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
Blue Cross Blue Shield	$47 - $953	30%
Blue Shield Mcare	$47 - $168	30%
Fhcn Pace Mcr Adv - All Plans	$47 - $168	30%
Medicare (plans)	$47 - $168	30%
Tricare	$47 - $168	30%
UnitedHealthcare	$47 - $217	30%
Upn-United Physcn Ntwrk Mcr Adv Profee Only-All Ot	$47	30%
Ah Employee Health Plan - All Plans	$52 - $302	33%
Incentive Hlth - All Plans	$52 - $302	33%
Hs Interplan-All Plans	$59 - $641	38%
Cal Forensic Med Grp - All Plans	$61 - $218	39%
Cigna	$61 - $443	39%
Blue Shield Epn	$63 - $302	40%
Blue Shield-All Other Plans	$66 - $418	42%
Healthnet Hmo/Ppo - All Other Plans	$69 - $448	44%
Aetna	$111 - $693	71%
Ccipa Medi-Cal - All Plans	$148 - $289	94%
Healthnet Medi-Cal	$148 - $291	94%
Medi-Cal	$148 - $222	94%
Upn-United Physcn Ntwrk Mcal Profee Only	$148	94%
Dignity Mcr Op Only - All Other Plans	$168	107%
Prime Health - All Plans	$168	107%
Prison Hlthcre - All Plans	$215	137%
Bright Health - All Plans	$244	155%
Dignity Mcal Op Only	$244	155%
Independence Op Only - All Plans	$244	155%
Western Growers - All Plans	$440	280%
Network By Design-All Plans	$669	426%
Multiplan - All Plans	$813	518%

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 $108.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77066.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Adventist Health Tulare is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77066.
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.