CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: UMass Memorial Health - Harrington Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $286
Cash Discount Price: $708
vs. Medicare Baseline: 2.27x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at UMass Memorial Health - Harrington Hospital is $286. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $708. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.27x the Medicare baseline. Located in 100 South Street, Southbridge, MA.

Cash / Self-Pay

$708

Average discount available for prompt cash payment at this facility.

Insurance Median

$286

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: $708 (561%)

Insurance Median: $286 (227%)

Cash: $708 (561% of Medicare)

Ins. Median: $286 (227% 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 227% of the Medicare baseline (a markup of 127%). 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
Mgb Mcr [10124]	$47 - $95	37%
Aetna	$50 - $708	40%
Tufts Mcr [10112]	$50 - $100	40%
Champva [11001]	$95	75%
Cigna	$95 - $755	75%
Institution [10406]	$95	75%
Tufts Us Family [11203]	$95	75%
Blue Cross Blue Shield	$98 - $286	78%
Commonwealth Care Alliance [10103]	$100	79%
Fallon Mcr Supp [20202]	$100	79%
Fallon Mcr [10105]	$100	79%
UnitedHealthcare	$100 - $708	79%
Senior Whole Health [10110]	$102	81%
Grants [20507]	$115	91%
Tufts Connectorcare [10507]	$162	128%
Tufts [11201]	$252 - $755	200%
Fallon Connectorcare [10503]	$309 - $928	245%
Workers Compensation [20501]	$345	273%
Medicaid / KanCare	$368	291%
Harvard Pilgrim [10701]	$408 - $490	323%
Hne [11108]	$461	365%
Wellpoint [11112]	$521	413%
First Health Network [11120]	$531	421%
Evernorth Behavioral Health [27]	$566	448%
Hsno/Free Care [10801]	$681	539%
Connecticare [11105]	$708	561%
Fallon Carelon Hlth [28]	$708	561%
Fallon Mcaid Carelon Hlth [29]	$708	561%
Masshealth Mcd Mbhp [38]	$708	561%
Wellsense Mcaid Carelon Hlth [21]	$708	561%

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 $708.
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 UMass Memorial Health - Harrington 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.