CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: UW Health

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $499
Cash Discount Price: $238
vs. Medicare Baseline: 3.18x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at UW Health is $499. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $238. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 3.18x the Medicare baseline. Located in 1401 East State Street, Rockford, IL.

Cash / Self-Pay

$238

Average discount available for prompt cash payment at this facility.

Insurance Median

$499

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: $238 (152%)

Insurance Median: $499 (318%)

Cash: $238 (152% of Medicare)

Ins. Median: $499 (318% 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 318% of the Medicare baseline (a markup of 218%). 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	$132 - $316	84%
Aetna	$189 - $461	120%
Quartz Fully Insured	$221	141%
Ecoh	$324 - $1,005	206%
Hfn	$324 - $502	206%
Alliance Premier Network	$348	222%
Quartz Aso	$349	222%
Medicare (plans)	$397 - $1,291	253%
The Alliance	$448	285%
UnitedHealthcare	$491 - $993	313%
Wps Ppo	$494	315%
Cigna	$509	324%
Beloit Healt System	$576	367%
Mercycare	$596	380%
First Health/Coventry	$628	400%
Health Payment Systems	$745	475%
Healthsmart	$745	475%
Sheboygan Employers Health Network	$794	506%
Multiplan	$888	566%

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 $238.
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 UW Health 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.