CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: West Valley Medical Center

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $359
Cash Discount Price: $601
vs. Medicare Baseline: 2.29x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at West Valley Medical Center is $359. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $601. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 2.29x the Medicare baseline. Located in 1717 Arlington Street, Caldwell, ID.

Cash / Self-Pay

$601

Average discount available for prompt cash payment at this facility.

Insurance Median

$359

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: $601 (383%)

Insurance Median: $359 (229%)

Cash: $601 (383% of Medicare)

Ins. Median: $359 (229% 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 229% of the Medicare baseline (a markup of 129%). 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
Blue Cross Blue Shield	$38 - $10,648	24%
Molina	$38 - $101	24%
Humana	$101 - $505	64%
Regence Blue Shield	$101	64%
St Luke'S Health Partners	$101 - $391	64%
Veteran'S Administration	$101	64%
United	$103 - $359	66%
Select Health Idaho (Eirmc Only)	$192	122%
Corizon Health	$223	142%
True Blue	$238	152%
Regence	$257	164%
Cigna	$337	215%
Pacificsource Health	$359	229%
Moda	$375	239%
Aetna	$476	303%
Four Rivers Hospice	$481	306%
Multiplan	$481	306%
Geha Ppo Usa	$511	326%
Coventry First Health	$541	345%
St Alphonsus Health	$541	345%

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 $601.
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 West Valley Medical Center 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.