CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: HCA Florida Poinciana Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $109
Cash Discount Price: $1,515
vs. Medicare Baseline: 0.86x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at HCA Florida Poinciana Hospital is $109. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,515. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.86x the Medicare baseline. Located in 325 Cypress Pkwy, Kissimmee, FL.

Cash / Self-Pay

$1,515

Average discount available for prompt cash payment at this facility.

Insurance Median

$109

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: $1,515 (1200%)

Insurance Median: $109 (86%)

Cash: $1,515 (1200% of Medicare)

Ins. Median: $109 (86% 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
Humana	$82 - $424	65%
Devoted Health	$87	69%
Ndms Definitive Care	$87	69%
United	$87 - $682	69%
Wellmed	$87	69%
Blue Cross Blue Shield	$89	70%
Fl Health Care Plan	$89	70%
Aetna	$90 - $455	71%
Sunshine State	$92	73%
Wellcare	$92	73%
Align Senior Care	$93	74%
American Health Plan	$93	74%
Avmed	$93 - $758	74%
Cigna	$93	74%
Florida Complete Care	$93	74%
Gold Kidney Of Florida	$95	75%
Centurion	$96	76%
Clear Spring Health	$96	76%
Careplus	$100	79%
Ultimate Health Plan	$100	79%
Longevity Health Plan	$105	83%
Freedom Health	$109	86%
Optimum	$109	86%
Solis Health Plan	$127	101%
Simply	$233	185%
Molina Healthcare	$288 - $409	228%
Sunshine State Health Plan	$386	306%
Plotkin Health	$758	600%
Prime Health Sheriff	$758	600%
Multiplan	$1,136 - $1,288	900%

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 $1,515.
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 HCA Florida Poinciana 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.