CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Saint Francis Hospital-Evanston

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $112
Cash Discount Price: $111
vs. Medicare Baseline: 0.71x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Saint Francis Hospital-Evanston is $112. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $111. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 0.71x the Medicare baseline. Located in 355 Ridge Ave, Evanston, IL.

Cash / Self-Pay

$111

Average discount available for prompt cash payment at this facility.

Insurance Median

$112

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: $111 (71%)

Insurance Median: $112 (71%)

Cash: $111 (71% of Medicare)

Ins. Median: $112 (71% 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
Aetna	$60 - $877	38%
Blue Cross Blue Shield	$60 - $157	38%
Countycare	$60	38%
Humana	$60 - $123	38%
Medicaid / KanCare	$60	38%
Meridian	$63 - $118	40%
Molina	$63 - $168	40%
Celtic (Wellcare)	$112	71%
Cigna	$112 - $877	71%
Clear Spring Health Of Illinois	$112	71%
Devoted Health	$112	71%
Essential Health Partners	$112 - $129	71%
Illinois Physicians Alliance	$112	71%
Longevity Health Plan Of Illinois	$112	71%
Medicare (plans)	$112	71%
Ravenswood Physicians Associates Ipa	$112	71%
Resurrection Physicians Provider Group Ipa	$112	71%
Self-Pay	$112	71%
Tricare	$112	71%
UnitedHealthcare	$112 - $140	71%
Zing Health Provider Network	$115	73%
Provider Partners Health Plan (Pphp)	$118	75%
Access Community Health Network	$134	85%
Clifton Health Systems	$174	111%
Ambetter / Centene	$181	115%
Imagine Health Network, Inc.	$232	148%

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 $111.
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 Saint Francis Hospital-Evanston 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.