CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Adventist Health Castle

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $313
Cash Discount Price: $142
vs. Medicare Baseline: 2.48x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Adventist Health Castle is $313. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $142. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.48x the Medicare baseline. Located in 640 Ulukahiki St, Kailua, HI.

Cash / Self-Pay

$142

Average discount available for prompt cash payment at this facility.

Insurance Median

$313

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: $142 (112%)

Insurance Median: $313 (248%)

Cash: $142 (112% of Medicare)

Ins. Median: $313 (248% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 248% of the Medicare baseline (a markup of 148%). 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	$51	40%
UnitedHealthcare	$85	67%
Alohacare Quest Mcaid - All Other Plans	$95 - $127	75%
Kfh Mcr Adv	$139	110%
Medicare (plans)	$139	110%
Ohana Health Plan - All Plans	$142	112%
Devoted Hlth Mcr Adv - All Plans	$146	116%
Hmsa Hmo	$156	124%
Hmsa Ppo - All Other Plans	$156	124%
Pacific Admin Ppo - All Plans	$242 - $322	192%
Hwmg/Hmaa - All Plans	$280 - $373	222%
Mdx Hawaii Ppo - All Plans	$303 - $405	240%
Health Alliance - All Plans	$304 - $406	241%
Kfh - All Other Plans	$323 - $431	256%
Uni Health Alliance - All Plans	$355 - $473	281%
First Health Ppo - All Plans	$357 - $477	283%
Medicaid / KanCare	$380 - $507	301%
State Of Hi Nonprofit - All Plans	$665 - $887	527%

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 $142.
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 Adventist Health Castle 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.