CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Adventist Health Castle

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $317
Cash Discount Price: $228
vs. Medicare Baseline: 2.02x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Adventist Health Castle is $317. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $228. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 2.02x the Medicare baseline. Located in 640 Ulukahiki St, Kailua, HI.

Cash / Self-Pay

$228

Average discount available for prompt cash payment at this facility.

Insurance Median

$317

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: $228 (145%)

Insurance Median: $317 (202%)

Cash: $228 (145% of Medicare)

Ins. Median: $317 (202% 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 202% of the Medicare baseline (a markup of 102%). 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
Multiplan Hmn - All Plans	$67	43%
UnitedHealthcare	$105	67%
Hmsa Hmo	$166	106%
Hmsa Ppo - All Other Plans	$166	106%
Kfh Mcr Adv	$173	110%
Medicare (plans)	$173	110%
Ohana Health Plan - All Plans	$176	112%
Alohacare Quest Mcaid - All Other Plans	$178	113%
Devoted Hlth Mcr Adv - All Plans	$181	115%
Pacific Admin Ppo - All Plans	$453	289%
Hwmg/Hmaa - All Plans	$525	334%
Mdx Hawaii Ppo - All Plans	$569	362%
Health Alliance - All Plans	$570	363%
Kfh - All Other Plans	$606	386%
Uni Health Alliance - All Plans	$665	424%
First Health Ppo - All Plans	$670	427%
Medicaid / KanCare	$713	454%
State Of Hi Nonprofit - All Plans	$1,248	795%

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 $228.
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 Castle 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.