CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Southcoast Hospitals Group

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $114
Cash Discount Price: $255
vs. Medicare Baseline: 0.90x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Southcoast Hospitals Group is $114. 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 $126.25, this hospital’s rate is 0.90x 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

$114

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: $255 (202%)

Insurance Median: $114 (90%)

Cash: $255 (202% of Medicare)

Ins. Median: $114 (90% 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.

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	72%
Aetna	$95 - $387	75%
Blue Cross Blue Shield	$95 - $205	75%
Evercare [1010304]	$95	75%
Medicare (plans)	$95 - $125	75%
Tufts Senior Care Options [1010315]	$95	75%
UnitedHealthcare	$95 - $145	75%
Wellsense Health Plan Senior Care Options [1020208	$96	76%
Commonwealth Care Alliance [1080501]	$98 - $99	78%
Eternal Health [1010322]	$104	82%
Tufts Health Public Plans [1010213]	$104 - $412	82%
Wellsense Health Plan Clarity Connectorcare & Meta	$109	86%
Fallon [1000114]	$133	105%
Wellpoint [1000102]	$166	131%
Harvard Pilgrim [1010602]	$189	150%
Tufts [1010701]	$213	169%
Cigna	$264	209%
Mass General Brigham Health Plan Commercial [10122	$287	227%
Mass General Brigham Health Plan Connectorcare [10	$287	227%
Group Insurance Service Center [1013001]	$305	242%
Innovative Health Plan [1025001]	$305	242%
Priority Health [1015001]	$305	242%
PHCS [1000125]	$331	262%
First Health [1000130]	$387	307%

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: 77067.

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 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.