CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Portneuf Medical Center

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $749
Cash Discount Price: $530
vs. Medicare Baseline: 4.77x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Portneuf Medical Center is $749. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $530. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 4.77x the Medicare baseline. Located in 777 Hospital Way, Pocatello, ID.

Cash / Self-Pay

$530

Average discount available for prompt cash payment at this facility.

Insurance Median

$749

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: $530 (338%)

Insurance Median: $749 (477%)

Cash: $530 (338% of Medicare)

Ins. Median: $749 (477% 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 477% of the Medicare baseline (a markup of 377%). 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
Aetna	$182 - $749	116%
Healthscope Benefits [2290]	$182	116%
UnitedHealthcare	$182 - $794	116%
Black Lung [6055]	$362	231%
Employee Benefit Management Services [2445]	$362 - $530	231%
Healthcare Highways [2210]	$362 - $839	231%
Lucent Health [6000]	$362	231%
Moda Health [6100]	$362	231%
Oncology Patient Assistance Programs [2295]	$362	231%
Pending Ssi [1616]	$362	231%
Web Tpa [2115]	$362	231%
Pacific Source Health Plans [2850]	$507	323%
Liberty Health Share Lhs/Medcost Solutions Llc [2400]	$530	338%
Medishare Christian Care [1645]	$530	338%
Worker'S Comp [2125]	$642 - $662	409%
Cigna	$650	414%
Enablecomp [1350]	$662	422%
Transamerican Life [1990]	$662	422%
First Health [1375]	$728	464%
Mailhandlers [1595]	$749	477%
Selecthealth [3740]	$749 - $794	477%
Geha [1415]	$794	506%
Humana	$794	506%
Administrative Concepts [1005]	$839	534%
Healthfirst [2395]	$839	534%
Healthnet [1495]	$839	534%
Hometown Health [2155]	$839	534%
Mayo Clinic Health Solutions [2280]	$839	534%
Meritain Health [1655]	$839	534%
Multiplan [1680]	$839	534%
Mutual Of Omaha [1685]	$839	534%
National Association Of Letter Carriers [1695]	$839	534%
New Era Life Insurance Company [1705]	$839	534%
Pan American Life Insurance Co [1770]	$839	534%
Pba [1775]	$839	534%
Phcs [1780]	$839	534%
Planned Administrators Inc [2360]	$839	534%
Trustmark [2030]	$839	534%
Ut Id Teamsters [3760]	$839	534%

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 $530.
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 Portneuf 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.