CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: New London Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $131
Cash Discount Price: $464
vs. Medicare Baseline: 1.04x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at New London Hospital is $131. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $464. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.04x the Medicare baseline. Located in 273 County Road, New London, NH.

Cash / Self-Pay

$464

Average discount available for prompt cash payment at this facility.

Insurance Median

$131

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$126.25

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $126.25 (100%)

Cash / Self-Pay: $464 (368%)

Insurance Median: $131 (104%)

Cash: $464 (368% of Medicare)

Ins. Median: $131 (104% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $126.25 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
Blue Cross Blue Shield	$35 - $932	28%
Martin'S Point Generations Advantage	$35 - $447	28%
Martin'S Point Health Care	$35 - $697	28%
UnitedHealthcare	$35 - $794	28%
Wellcare Health Plans	$36 - $447	29%
Wellsense Health Plan	$37 - $447	29%
Aetna	$40 - $877	32%
Granite State Health Plan	$41 - $512	32%
Amerihealth Caritas Nh	$42 - $517	33%
Harvard Pilgrim Health Care Of Ne	$42 - $724	33%
Ambetter / Centene	$46 - $447	36%
Cigna	$48 - $687	38%
Tufts Health Plan	$702 - $731	556%
Coventry	$959	760%
Multiplan	$964	764%

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 $464.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77067.

Insurance In-Network Protection Plan

Contact your insurance company to confirm New London Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77067.
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.