CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Alice Peck Day Memorial Hospital

Billing Code: 77067 (CPT)

The BaseRate · fair price medium confidence

A fair price for this

$186

about 1.5× the $126 Medicare rate · typically $78–$588

modeled estimate · not a bill or quote

What this hospital charges insurers

$438

Well above the fair price

about $252 over the fair price · 3.5× Medicare

Medicare pays $126 Fair price $186 This hospital $438 Cash price $494 Hospital's list price $917

How we calculate the fair BaseRate →

How this hospital compares to other NH hospitals

Highest price of the 9 NH hospitals we have prices for — worth calling around.

Cheapest $86 Priciest $438

Black dot = this hospital, among the 9 NH hospitals with a price for this procedure. Full list below.

A fair price for a Screening mammogram (both breasts) is about $186 (about 1.5× the $126 Medicare rate). Alice Peck Day Memorial Hospital charges insurers about $438, or about $494 in cash — well above the fair price. Located in Lebanon, NH.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $186. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company	Price range	vs. Medicare
UnitedHealthcaremajor	$93 - $143	74%
Blue Cross Blue Shieldmajor	$453 - $816	359%
Aetnamajor	$825 - $871	653%
Cignamajor	$702 - $750	556%
Humanamajor	$954	756%
Harvard Pilgrim	$570 - $795	451%
MVP Health Care	$834	661%
Tufts Health Plan	$672	532%
+ 3 smaller / regional plans	$702 - $709

Government programs also on file: Medicaid.

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price (about 494), before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the CPT code on your bill matches exactly: 77067.

Insurance Before you use insurance

Call your insurance company to confirm Alice Peck Day Memorial Hospital is in-network.
Ask your insurer whether prior approval is required for CPT code 77067.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Alice Peck Day Memorial Hospital

Compare: Screening mammogram (both breasts) at other NH hospitals

Insurance negotiated median for the same procedure, sorted lowest first.