CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Good Samaritan Medical Center

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $235
Cash Discount Price: $229
vs. Medicare Baseline: 1.50x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Good Samaritan Medical Center is $235. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $229. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.50x the Medicare baseline. Located in 235 North Pearl Street, Brockton, MA.

Cash / Self-Pay

$229

Average discount available for prompt cash payment at this facility.

Insurance Median

$235

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: $229 (146%)

Insurance Median: $235 (150%)

Cash: $229 (146% of Medicare)

Ins. Median: $235 (150% 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	$132 - $387	84%
Blue Cross Blue Shield	$132 - $268	84%
Humana	$132	84%
Medicare (plans)	$132 - $171	84%
Neighborhood Pace [1206]	$132	84%
Ubh Hphc [8016]	$132	84%
United Community Plan [1202]	$132	84%
UnitedHealthcare	$132	84%
Veterans Admin [9003]	$132	84%
Zzzcovid19 Hrsa Uninsured Testing And Treatment Fund [500010]	$132	84%
Eternalhealth [1227]	$140	89%
Cca [1215]	$171	109%
Fallon [8008]	$171	109%
Zzzcca Onecare [1216]	$171	109%
Senior Whole Health [1210]	$198	126%
Harvard Pilgrim Health Care [8001]	$235	150%
Mass General Brigham Health Plan Commercial [8009]	$295	188%
Mass General Brigham Health Plan Prime [7003]	$295	188%
Cigna	$306 - $457	195%
Unicare [8004]	$382	243%
Wellpoint [2034]	$382	243%
Meritain Health [1023]	$387	247%
Tufts [8002]	$390 - $457	248%
Hsn Bad Debt [4003]	$395	252%
Hsn Confidential [4007]	$395	252%
Hsn Dental [4006]	$395	252%
Hsn Partial [4002]	$395	252%
Hsn [4001]	$395	252%

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 $229.
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 Good Samaritan Medical Center 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.