CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Palos Community Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $561
Cash Discount Price: $524
vs. Medicare Baseline: 4.44x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Palos Community Hospital is $561. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $524. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 4.44x the Medicare baseline. Located in 12251 South 80Th Avenue, Palos Heights, IL.

Cash / Self-Pay

$524

Average discount available for prompt cash payment at this facility.

Insurance Median

$561

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: $524 (415%)

Insurance Median: $561 (444%)

Cash: $524 (415% of Medicare)

Ins. Median: $561 (444% 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 444% of the Medicare baseline (a markup of 344%). 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	$120 - $748	95%
Aetna	$161 - $748	128%
Carelon Behavioral Health [159]	$374	296%
Healthlink [125]	$374 - $748	296%
First Health Plan [6034]	$425 - $561	337%
Magellan Behavioral Hlth [136]	$449	356%
The Alliance [1703]	$480	380%
Multiplan/Phcs [142]	$524 - $748	415%
Compsych [112]	$561	444%
Beechstreet [176]	$598	474%
Cigna	$598 - $748	474%
Health'S Finest Network [126]	$636	504%
Galaxy Health Network [220]	$748	592%
Global Excel [1712]	$748	592%
Health Alliance [181]	$748	592%
UnitedHealthcare	$748	592%

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 $524.
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 Palos Community Hospital 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.