CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: North Hawaii Community Hospital, Inc

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $47
Cash Discount Price: $488
vs. Medicare Baseline: 0.30x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at North Hawaii Community Hospital, Inc is $47. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $488. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 0.30x the Medicare baseline. Located in 67 1125 Mamalahoa Highway, Kamuela, HI.

Cash / Self-Pay

$488

Average discount available for prompt cash payment at this facility.

Insurance Median

$47

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: $488 (311%)

Insurance Median: $47 (30%)

Cash: $488 (311% of Medicare)

Ins. Median: $47 (30% 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.

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
Alohacare	$47	30%
Hmsa	$47 - $205	30%
Kaiser	$47 - $132	30%
Mdx Hawaii	$47	30%
Ohana Care	$47	30%
United Behavioral Health	$47	30%
UnitedHealthcare	$47	30%
Hawaii Community Health Alliance	$85	54%
Hawaii Mainland Administrators	$85	54%
University Health Alliance	$179	114%
Hawaii Laborers	$337	215%

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 $488.
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 North Hawaii Community Hospital, Inc 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.