CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Adventist Health Vallejo

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $558
Cash Discount Price: $147
vs. Medicare Baseline: 3.55x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Adventist Health Vallejo is $558. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $147. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 3.55x the Medicare baseline. Located in 525 Oregon St, Vallejo, CA.

Cash / Self-Pay

$147

Average discount available for prompt cash payment at this facility.

Insurance Median

$558

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: $147 (94%)

Insurance Median: $558 (355%)

Cash: $147 (94% of Medicare)

Ins. Median: $558 (355% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 355% of the Medicare baseline (a markup of 255%). 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
Blue Shield Non-Epn-All Other Plans	$44 - $721	28%
Blue Shield Mcr Adv	$46 - $164	29%
Medicare (plans)	$46 - $164	29%
Napa County Mcal Child	$46 - $164	29%
Tricare	$46 - $164	29%
Ah Employee Health Plan-All Plans	$51 - $296	32%
Interplan-All Plans	$56 - $1,010	36%
Kaiser-All Plans	$56 - $1,305	36%
Cigna	$61 - $1,243	39%
UnitedHealthcare	$62 - $991	39%
Aetna	$66 - $795	42%
Western Growers-All Plans	$68 - $824	43%
Phcs-All Plans	$92 - $855	59%
Blue Cross Blue Shield	$104 - $1,119	66%
Health Management Network-All Plans	$142 - $1,321	90%
Medi-Cal	$148 - $222	94%
Three Rivers-All Plans	$150 - $1,399	96%
Va Mcr-All Other Plans	$164	104%
Va Medi-Cal	$222	141%
Healthnet-All Plans	$352	224%
Blue Shield Behav Hlth	$383 - $699	244%
Blue Shield Epn	$401 - $732	255%
Choicecare-All Plans	$596 - $1,088	380%
Beech Street-All Plans	$638 - $1,166	406%
Galaxy Network-All Plans	$766 - $1,399	488%

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 $147.
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 Vallejo 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.