CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Southcoast Hospitals Group

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $129
Cash Discount Price: $255
vs. Medicare Baseline: 0.82x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Southcoast Hospitals Group is $129. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $255. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 0.82x the Medicare baseline. Located in 363 Highland Avenue, Fall River, MA.

Cash / Self-Pay

$255

Average discount available for prompt cash payment at this facility.

Insurance Median

$129

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: $255 (162%)

Insurance Median: $129 (82%)

Cash: $255 (162% of Medicare)

Ins. Median: $129 (82% 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
Wellsense Health Plan [1010202]	$91	58%
Tufts Health Public Plans [1010213]	$104 - $412	66%
Wellsense Health Plan Clarity Connectorcare & Meta	$109	69%
Aetna	$115 - $387	73%
Blue Cross Blue Shield	$115 - $214	73%
Evercare [1010304]	$115	73%
Medicare (plans)	$115 - $138	73%
Tufts Senior Care Options [1010315]	$115	73%
UnitedHealthcare	$115 - $176	73%
Wellsense Health Plan Senior Care Options [1020208	$116	74%
Commonwealth Care Alliance [1080501]	$118 - $119	75%
Eternal Health [1010322]	$126	80%
Fallon [1000114]	$161	103%
Wellpoint [1000102]	$177	113%
Tufts [1010701]	$213	136%
Harvard Pilgrim [1010602]	$228	145%
Mass General Brigham Health Plan Commercial [10122	$287	183%
Mass General Brigham Health Plan Connectorcare [10	$287	183%
Group Insurance Service Center [1013001]	$305	194%
Innovative Health Plan [1025001]	$305	194%
Priority Health [1015001]	$305	194%
Cigna	$319	203%
PHCS [1000125]	$331	211%
First Health [1000130]	$387	247%

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 $255.
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 Southcoast Hospitals Group 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.