CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: North Carolina Baptist Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $471
Cash Discount Price: $731
vs. Medicare Baseline: 3.00x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at North Carolina Baptist Hospital is $471. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $731. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 3.00x the Medicare baseline. Located in Medical Center Boulevard, Winston-Salem, NC.

Cash / Self-Pay

$731

Average discount available for prompt cash payment at this facility.

Insurance Median

$471

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: $731 (466%)

Insurance Median: $471 (300%)

Cash: $731 (466% of Medicare)

Ins. Median: $471 (300% 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 300% of the Medicare baseline (a markup of 200%). 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
Aetna	$100 - $1,276	64%
Apex	$100	64%
Blue Cross Blue Shield	$100 - $481	64%
Cigna	$100 - $901	64%
Devoted	$100	64%
Healthteam	$100	64%
UnitedHealthcare	$100 - $518	64%
Wellcare	$100 - $344	64%
Humana	$101 - $821	64%
Medicare (plans)	$101	64%
Liberty	$115	73%
Medcost	$282 - $998	180%
Amerihealth	$321 - $405	204%
Carolina Complete	$321 - $339	204%
Health Blue	$321 - $339	204%
Partners	$321 - $339	204%
Vaya	$325 - $343	207%
Alliance	$328 - $346	209%
Trillium	$331 - $349	211%
Ambetter / Centene	$384 - $405	245%
Oscar	$427 - $540	272%
Directnet	$840 - $887	535%
Cone Health	$995 - $1,051	634%
Healthgram	$995 - $1,051	634%
First Carolina Care	$1,138 - $1,201	725%
Private Healthcare Systems	$1,166 - $1,231	743%
Multiplan	$1,280 - $1,351	815%

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 $731.
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 North Carolina Baptist Hospital 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.