CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Mary Hitchcock Memorial Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $235
Cash Discount Price: $226
vs. Medicare Baseline: 1.50x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Mary Hitchcock Memorial Hospital is $235. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $226. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.50x the Medicare baseline. Located in 1 Medical Center Drive, Lebanon, NH.

Cash / Self-Pay

$226

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: $226 (144%)

Insurance Median: $235 (150%)

Cash: $226 (144% 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
Beacon Health Strategies/Carelon	$33 - $134	21%
Amerihealth Caritas Nh	$34 - $126	22%
Granite State Health Plan	$34 - $138	22%
Blue Cross Blue Shield	$46 - $955	29%
Martin'S Point Generations Advantage	$46 - $158	29%
Mvp	$46 - $734	29%
UnitedHealthcare	$46 - $842	29%
Aetna	$47 - $769	30%
Cigna	$47 - $752	30%
Martin'S Point Health Care	$47 - $378	30%
Wellcare Health Plans	$47 - $164	30%
Wellsense Health Plan	$47 - $165	30%
Ambetter / Centene	$48 - $368	31%
Harvard Pilgrim Health Care Of Ne	$57 - $831	36%
Mass General Brigham Health Plan	$133 - $682	85%
Tufts Health Plan	$154 - $639	98%
Maine Community Health Options	$243 - $806	155%
Coventry	$331 - $954	211%
First Health/Hcvm	$331 - $954	211%
Phcs	$343 - $986	218%
Corvel	$351 - $1,008	224%
Ccmsi	$362 - $1,041	231%

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 $226.
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 Mary Hitchcock Memorial 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.