CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: South Miami Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $127
Cash Discount Price: $475
vs. Medicare Baseline: 1.01x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at South Miami Hospital is $127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $475. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.01x the Medicare baseline. Located in 6200 Sw 73Rd St, Miami, FL.

Cash / Self-Pay

$475

Average discount available for prompt cash payment at this facility.

Insurance Median

$127

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: $475 (376%)

Insurance Median: $127 (101%)

Cash: $475 (376% of Medicare)

Ins. Median: $127 (101% 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.

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
Amerigroup	$14 - $29	11%
Medicaid / KanCare	$14 - $32	11%
Sunshine State	$15 - $31	12%
UnitedHealthcare	$15 - $731	12%
Wellcare	$15 - $30	12%
Aetna	$16 - $585	13%
Vista	$16 - $31	13%
Medicare (plans)	$95 - $129	75%
Blue Cross Blue Shield	$99 - $474	78%
Medica Health Plan	$102	81%
Humana	$104	82%
Avmed	$105 - $362	83%
Leon Medical	$105	83%
Cigna	$109 - $585	86%
Non Contracted	$268	212%
Amerihealth	$329	261%
International	$475	376%
Dimension Health Plan	$548 - $658	434%
Affordable	$621	492%
Phcs	$658	521%
Quality Health	$658	521%

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 $475.
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 South Miami 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.