CMS Price Transparency Data
Screening mammogram (both breasts)
Facility: Palmetto General Hospital
Billing Code: 77067 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 77067
- Insurance Median: $162
- Cash Discount Price: $633
- vs. Medicare Baseline: 1.28x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Palmetto General Hospital is $162. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $633. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.28x the Medicare baseline. Located in 2001 W 68Th St, Hialeah, FL.
Cash / Self-Pay
$633
Average discount available for prompt cash payment at this facility.
Insurance Median
$162
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: $633 (501%)
Insurance Median: $162 (128%)
Cash: $633 (501% of Medicare)
Ins. Median: $162 (128% 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
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Aetna | $15 - $556 | 12% |
| Humana | $30 - $317 | 24% |
| Medicaid / KanCare | $30 - $780 | 24% |
| UnitedHealthcare | $31 - $91 | 25% |
| Veterans Administration Mill Bill | $63 | 50% |
| Medicare (plans) | $82 - $780 | 65% |
| Cigna | $85 - $390 | 67% |
| Devoted Health | $91 | 72% |
| Leon Health Inc | $91 | 72% |
| Bristol Hospice- Miami Dade Llc | $92 | 73% |
| Catholic Hospice | $92 | 73% |
| Compassionate Care Hospice Of Miami Dade And The Fl Keys Inc | $92 | 73% |
| Employer Direct Healthcare | $92 - $162 | 73% |
| Hospice Other | $92 | 73% |
| Ima Evalutations Inc | $92 | 73% |
| Odyssey Healthcare Of Marion County Dba Kindred Hospice | $92 | 73% |
| Opuscare Of South Fl | $92 | 73% |
| Seasons Hospice And Pallative Care Of Southern Florida Inc | $92 | 73% |
| Select Specialty Hospital | $92 | 73% |
| Tricare | $92 | 73% |
| Veterans Administration Vaccn | $92 | 73% |
| Vitas Healthcare Hospice | $92 | 73% |
| Westchester General Hospital | $92 | 73% |
| Healthsun Health Plans | $95 - $133 | 75% |
| Longevity Health Plan | $97 | 77% |
| Florida Pace Centers | $109 | 86% |
| Bright Health Management Commercial | $111 | 88% |
| Self Pay/Uninsured | $113 - $159 | 90% |
| Avmed Broad Network | $117 | 93% |
| Naphcare Inc | $127 | 101% |
| Bc/Bs Myblue Hmo Hix | $135 | 107% |
| Bc/Bs Of Fl Simplyblue | $142 | 112% |
| Bc/Bs Of Fl Miami Dade Blue Select | $149 | 118% |
| Imagine Health | $150 | 119% |
| Avmed Exchange | $162 | 128% |
| Ambetter / Centene | $171 | 135% |
| Molina Marketplace Program Exchange | $176 | 139% |
| Oscar Health Plan Hix | $182 | 144% |
| Auto Insurance | $185 | 147% |
| Avmed Select Network | $189 | 150% |
| Bc/Bs Of Fl Network Blue | $190 | 150% |
| Bc/Bs Of Fl Health Options Hmo | $193 | 153% |
| Amerihealth Caritas Next Exchange | $199 | 158% |
| Bc/Bs Of Fl Ppo | $203 | 161% |
| Bc/Bs Of Fl Blue Select Exchange Non Par | $211 | 167% |
| Liga Contra El Cancer | $243 - $390 | 192% |
| Bc/Bs Of Fl Phs | $244 - $392 | 193% |
| Magellan Behavioral Health | $292 - $468 | 231% |
| Dimensions International | $316 - $507 | 250% |
| First Health | $326 - $523 | 258% |
| Dimension Health Ppo | $365 - $585 | 289% |
| Dimension Health Wc | $365 - $585 | 289% |
| Workers Compensation | $365 - $585 | 289% |
| Beacon Health Strategies Commercial | $486 - $780 | 385% |
| Commercial Non-Contracted | $486 - $780 | 385% |
| Self Pay - Mcd Pending 100 Percent | $486 - $780 | 385% |
| Single Case Agreement | $486 - $780 | 385% |
| United Behavioral Health Psych | $486 - $780 | 385% |