CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Sanford Hillsboro

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $510
Cash Discount Price: $494
vs. Medicare Baseline: 3.25x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Sanford Hillsboro is $510. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $494. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 3.25x the Medicare baseline. Located in 12 Third Street Se, Hillsboro, ND.

Cash / Self-Pay

$494

Average discount available for prompt cash payment at this facility.

Insurance Median

$510

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: $494 (315%)

Insurance Median: $510 (325%)

Cash: $494 (315% of Medicare)

Ins. Median: $510 (325% 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 325% of the Medicare baseline (a markup of 225%). 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
Blue Cross Blue Shield	$150 - $572	96%
Sanford Health Plan Align	$282	180%
Ucare	$303 - $543	193%
Aetna	$305 - $537	194%
Health Partners	$305 - $482	194%
Medicare (plans)	$305	194%
UnitedHealthcare	$305 - $516	194%
Primewest	$311	198%
Security Health Plan	$340	217%
Sanford Health Plan	$488 - $574	311%
Medica	$510 - $545	325%
First Choice Health Network	$556	354%
Healthez	$556	354%
Multiplan	$556	354%

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 $494.
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 Sanford Hillsboro 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.