CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Capital Health Medical Center - Hopewell

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $626
Cash Discount Price: $8,699
vs. Medicare Baseline: 4.96x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Capital Health Medical Center - Hopewell is $626. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $8,699. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 4.96x the Medicare baseline. Located in One Capital Way, Pennington, NJ.

Cash / Self-Pay

$8,699

Average discount available for prompt cash payment at this facility.

Insurance Median

$626

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: $8,699 (6890%)

Insurance Median: $626 (496%)

Cash: $8,699 (6890% of Medicare)

Ins. Median: $626 (496% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 496% of the Medicare baseline (a markup of 396%). 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
Medicare (plans)	$102	81%
Clover	$137	109%
Wellpoint	$137 - $501	109%
Humana	$139	110%
Fidelis	$159	126%
Oxford Benefit Plan	$225	178%
UnitedHealthcare	$232 - $464	184%
Medicaid / KanCare	$248 - $495	196%
Cigna	$250 - $8,698	198%
Aetna	$313 - $4,117	248%
Blue Cross Blue Shield	$578 - $1,387	458%
Multiplan	$4,929 - $9,858	3904%

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 $8,699.
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 Capital Health Medical Center - Hopewell 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.