CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: South Miami Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $150
Cash Discount Price: $560
vs. Medicare Baseline: 0.96x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at South Miami Hospital is $150. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $560. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 0.96x the Medicare baseline. Located in 6200 Sw 73Rd St, Miami, FL.

Cash / Self-Pay

$560

Average discount available for prompt cash payment at this facility.

Insurance Median

$150

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: $560 (357%)

Insurance Median: $150 (96%)

Cash: $560 (357% of Medicare)

Ins. Median: $150 (96% 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
Medicaid / KanCare	$16 - $32	10%
Amerigroup	$29	18%
UnitedHealthcare	$30 - $862	19%
Wellcare	$30	19%
Aetna	$31 - $690	20%
Sunshine State	$31	20%
Vista	$31	20%
Medicare (plans)	$116 - $157	74%
Blue Cross Blue Shield	$120 - $559	76%
Medica Health Plan	$124	79%
Humana	$127	81%
Avmed	$128 - $427	82%
Leon Medical	$128	82%
Cigna	$132 - $690	84%
Non Contracted	$316	201%
Amerihealth	$388	247%
International	$560	357%
Dimension Health Plan	$646 - $776	412%
Affordable	$733	467%
Phcs	$776	494%
Quality Health	$776	494%

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 $560.
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 South Miami Hospital 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.