CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Transylvania Regional Hospital, Inc

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $104
Cash Discount Price: $484
vs. Medicare Baseline: 0.66x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Transylvania Regional Hospital, Inc is $104. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $484. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 0.66x the Medicare baseline. Located in 90 Hospital Drive Po Box 1116, Brevard, NC.

Cash / Self-Pay

$484

Average discount available for prompt cash payment at this facility.

Insurance Median

$104

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: $484 (308%)

Insurance Median: $104 (66%)

Cash: $484 (308% of Medicare)

Ins. Median: $104 (66% 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
Carepartners Hospice	$79 - $99	50%
Blue Cross Blue Shield	$92 - $97	59%
United	$93 - $218	59%
Wellcare	$94 - $102	60%
Amerihealth	$95	61%
Partners Health Management	$96	61%
Vaya Health	$96	61%
Apex Health	$97 - $99	62%
Alignment Health	$99 - $101	63%
Devoted Health	$99 - $101	63%
Nhc Advantage	$100 - $103	64%
Aetna	$101 - $350	64%
Cigna	$102 - $247	65%
Humana	$102 - $103	65%
Amerihealth Caritas	$104 - $199	66%
Healthteam Advantage	$104 - $109	66%
Provider Partners Health Plan	$104 - $105	66%
Pruitthealth Premier	$104	66%
Troy Healthcare	$104 - $107	66%
Longevity Health Plan	$106 - $119	68%
Caresource	$213	136%
Medcost	$271 - $412	173%
Magellan	$291	185%
Magellan Behavioral Health	$291	185%
Multiplan	$388	247%
Avalon Administrative Services	$412	262%
Prime Health	$426 - $436	271%

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 $484.
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 Transylvania Regional Hospital, Inc 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.