CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Kaleida Health

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $127
Cash Discount Price: $383
vs. Medicare Baseline: 0.81x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Kaleida Health is $127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $383. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 0.81x the Medicare baseline. Located in 100 High Street, Buffalo, NY.

Cash / Self-Pay

$383

Average discount available for prompt cash payment at this facility.

Insurance Median

$127

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: $383 (244%)

Insurance Median: $127 (81%)

Cash: $383 (244% of Medicare)

Ins. Median: $127 (81% 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
Independent Health Association	$61 - $219	39%
Independent Health Association - Wchob	$63 - $219	40%
Blue Cross Blue Shield	$72 - $391	46%
Tricare	$100	64%
Univera	$103 - $164	66%
Wellcare	$109	69%
Aetna	$111 - $128	71%
Fidelis	$113	72%
UnitedHealthcare	$114	73%
Cigna	$123 - $149	78%
Ghi/Emblem Health	$123 - $154	78%
Ghi/Emblem Health - Wchob	$123 - $154	78%
Magnacare	$128 - $164	82%
Magnacare - Wchob	$128 - $164	82%
Univera - Wchob	$131 - $164	83%

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 $383.
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 Kaleida Health 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.