CMS Price Transparency Data
Diagnostic mammogram (both breasts)
Facility: Trinity Health Oakland Hospital
Billing Code: 77066 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 77066
- Insurance Median: $573
- Cash Discount Price: $548
- vs. Medicare Baseline: 3.65x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Trinity Health Oakland Hospital is $573. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $548. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 3.65x the Medicare baseline. Located in 44405 Woodward Ave, Pontiac, MI.
Cash / Self-Pay
$548
Average discount available for prompt cash payment at this facility.
Insurance Median
$573
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: $548 (349%)
Insurance Median: $573 (365%)
Cash: $548 (349% of Medicare)
Ins. Median: $573 (365% 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 365% of the Medicare baseline (a markup of 265%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
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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 | $59 - $249 | 38% |
| Medicaid / KanCare | $59 - $60 | 38% |
| Aetna | $105 - $386 | 67% |
| Blue Care Network Advantage | $105 | 67% |
| Medicare (plans) | $105 - $107 | 67% |
| Align Senior Care | $107 | 68% |
| Hospice Advantage | $107 | 68% |
| UnitedHealthcare | $110 - $632 | 70% |
| Cca - Zing Health | $113 | 72% |
| Longevity Ipa Of Michigan Llc Health Plan Isnp | $121 | 77% |
| Molina Marketplace | $139 | 89% |
| Vitalcore | $157 | 100% |
| Health Cost Solutions | $166 | 106% |
| Wellpath | $166 | 106% |
| Asr Health Benefits | $224 | 143% |
| Caresource | $224 | 143% |
| Hap | $224 - $614 | 143% |
| Varipro | $224 | 143% |
| Priority Health | $227 - $252 | 145% |
| Employee Benefit Logistic | $241 | 154% |
| Bcn Domestic | $249 | 159% |
| Blue Benefit Administrators Of Massachusetts | $249 | 159% |
| Blue Care Network | $249 | 159% |
| Blue Distinction Transplant | $249 | 159% |
| Blue Shield - Ca | $249 | 159% |
| Blue Shield - Id (Regence) | $249 | 159% |
| Blue Shield - Ny Highmark Northeastern | $249 | 159% |
| Blue Shield - Ny Highmark Western | $249 | 159% |
| Blue Shield - Pa (Highmark) | $249 | 159% |
| Blue Shield - Wa (Regence) | $249 | 159% |
| Health Choices | $249 - $619 | 159% |
| Kaiser Domestic | $249 | 159% |
| Wc Accident Fund | $256 | 163% |
| Wc Advantage | $256 | 163% |
| Wc Aig | $256 | 163% |
| Wc Allied | $256 | 163% |
| Wc Amerisure | $256 | 163% |
| Wc Amtrust | $256 | 163% |
| Wc Asu Risk Mgt | $256 | 163% |
| Wc Berkley Admin | $256 | 163% |
| Wc Broadspire | $256 | 163% |
| Wc Bunch & Associates | $256 | 163% |
| Wc Ccmsi | $256 | 163% |
| Wc Emc Insurance Company | $256 | 163% |
| Wc Esis | $256 | 163% |
| Wc Fcci | $256 | 163% |
| Wc Federated | $256 | 163% |
| Wc Gallagher Bassett | $256 | 163% |
| Wc Genex Care For Ohio | $256 | 163% |
| Wc Guard Insurance Company | $256 | 163% |
| Wc Hartford | $256 | 163% |
| Wc Liberty Mutual | $256 | 163% |
| Wc Meijers | $256 | 163% |
| Wc Michigan | $256 | 163% |
| Wc Mitchell Frankenmuth | $256 | 163% |
| Wc Pma | $256 | 163% |
| Wc Sedgwick | $256 | 163% |
| Wc Sentry | $256 | 163% |
| Wc Travelers | $256 | 163% |
| Wc Tristar | $256 | 163% |
| Wc Walmart | $256 | 163% |
| Wc Zurich | $256 | 163% |
| U Of M Health Plan | $346 | 220% |
| Acs Benefit Services | $371 | 236% |
| Allied Benefit Systems | $371 | 236% |
| Claimchoice Adminstrators | $371 | 236% |
| Consociate | $371 | 236% |
| Cypress Benefit Administrators | $371 | 236% |
| Forest County Potawatomi | $371 | 236% |
| Health Smart | $371 | 236% |
| Healthgram | $371 | 236% |
| Healthscope | $371 | 236% |
| Secureone Preferred United Plans | $371 | 236% |
| Sisco Benefits | $371 | 236% |
| The Health Plan | $371 | 236% |
| Trustmark Small Business Benefits | $371 | 236% |
| Unified Group Services | $371 | 236% |
| Webtpa | $371 | 236% |
| Geha | $386 - $632 | 246% |
| Medical Mutual | $386 | 246% |
| Meritain | $386 | 246% |
| Mclaren Health | $405 - $442 | 258% |
| Carelon Behavioral Health | $422 | 269% |
| Magellan Behavioral Health | $506 | 322% |
| 1199 National Benefit Fund | $573 | 365% |
| Allied National Global Care | $573 | 365% |
| Asrm - Reliance Standard Life Insurance | $573 | 365% |
| Christian Care Ministry | $573 | 365% |
| Dean Health | $573 | 365% |
| Fallon Health | $573 | 365% |
| Family Life Insurance Company | $573 | 365% |
| Ghc Scw | $573 | 365% |
| Group Pension Administrators | $573 | 365% |
| International Benefit Administrators | $573 | 365% |
| Lifetime Benefit Solutions | $573 | 365% |
| Manhattan Life | $573 | 365% |
| Medi Share | $573 | 365% |
| Multiplan | $573 | 365% |
| Mvp | $573 | 365% |
| Pai | $573 | 365% |
| Pan-American Life | $573 | 365% |
| Paramount Hmo | $573 | 365% |
| Phcs | $573 | 365% |
| Trinity Health Share | $573 | 365% |
| Health Partners | $614 | 391% |
| Tufts Health Plan | $614 | 391% |
| Access Health | $619 | 394% |
| Acclaim | $619 | 394% |
| Administrative Concepts | $619 | 394% |
| Allegeant | $619 | 394% |
| Ameriben | $619 | 394% |
| American Family | $619 | 394% |
| American Healthcare Alliance | $619 | 394% |
| American National | $619 | 394% |
| American Republic | $619 | 394% |
| Amerihealth | $619 | 394% |
| Aultcare | $619 | 394% |
| Automated Benefit Services | $619 | 394% |
| Auxiant | $619 | 394% |
| Benefit Administrative Systems,Llc | $619 | 394% |
| Boon Chapman | $619 | 394% |
| Cam Administrative Services | $619 | 394% |
| Christian Brother Services | $619 | 394% |
| Christian Brothers Holy Cross | $619 | 394% |
| Comprehensive Benefits | $619 | 394% |
| Continental Life Insurance | $619 | 394% |
| Custom Benefit Administrators | $619 | 394% |
| Employee Benefit Concepts | $619 | 394% |
| Employee Benefit Management | $619 | 394% |
| Enterprise Group Planning | $619 | 394% |
| Freedom Life Insurance Company | $619 | 394% |
| Group Administrators | $619 | 394% |
| Group Marketing Services | $619 | 394% |
| Guardian | $619 | 394% |
| Health America | $619 | 394% |
| Healthcare Management Admin | $619 | 394% |
| Healthez | $619 | 394% |
| Humana | $619 | 394% |
| Insight | $619 | 394% |
| Intercare | $619 | 394% |
| Jfp Benefit Management | $619 | 394% |
| Jp Farley Corporation | $619 | 394% |
| Key Benefit Administrator | $619 | 394% |
| Liberty Union Life Assurance Co | $619 | 394% |
| Lucent Health | $619 | 394% |
| Luminare Health | $619 | 394% |
| Luminare Health (Detroit) | $619 | 394% |
| Magnacare | $619 | 394% |
| Medben | $619 | 394% |
| Medcost | $619 | 394% |
| Mutual Health Services | $619 | 394% |
| Mutual Of Omaha | $619 | 394% |
| Ncas | $619 | 394% |
| Nippon Life Ins | $619 | 394% |
| Nova | $619 | 394% |
| Painters Union Insurance Fund | $619 | 394% |
| Physicians Mutual | $619 | 394% |
| Plumbers Local 98 Insurance Fund | $619 | 394% |
| Prairie States | $619 | 394% |
| Preferred One | $619 | 394% |
| Primary Physician Care | $619 | 394% |
| Professional Benefit Administrators | $619 | 394% |
| Siho Insurance Services | $619 | 394% |
| The Loomis Company | $619 | 394% |
| Unicare | $619 | 394% |
| Us Health And Life | $619 | 394% |
| Valenz | $619 | 394% |
| Western & Southern Financial Group | $619 | 394% |
| Wps | $619 | 394% |
| Cigna | $625 | 398% |
| Coventry | $635 | 405% |
| First Health | $635 | 405% |
| Prime Health Services | $674 | 429% |
| Three Rivers Provider Network | $759 | 484% |
| Cmh Detroit Wayne Integrated Health Network | $843 | 537% |
| Cmh Lenawee County | $843 | 537% |
| Cmh Livingston County | $843 | 537% |
| Cmh Misc | $843 | 537% |
| Cmh Monroe County | $843 | 537% |
| Cmh Oakland County | $843 | 537% |
| Cmh Washtenaw County | $843 | 537% |