CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Jones Memorial Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $105
Cash Discount Price: $136
vs. Medicare Baseline: 0.67x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Jones Memorial Hospital is $105. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $136. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 0.67x the Medicare baseline. Located in 191 North Main Street, Wellsville, NY.

Cash / Self-Pay

$136

Average discount available for prompt cash payment at this facility.

Insurance Median

$105

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: $136 (87%)

Insurance Median: $105 (67%)

Cash: $136 (87% of Medicare)

Ins. Median: $105 (67% 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
Medicaid / KanCare	$59 - $220	38%
Fidelis 5155	$59 - $98	38%
UnitedHealthcare	$59 - $105	38%
Blue Cross Blue Shield	$59 - $205	38%
Univera Healthcare 1706	$59 - $98	38%
Empire Plan 5179	$105	67%
Total Senior Care 1319	$105	67%
Humana	$105	67%
UPMC Health Plan 5138	$105	67%
Medicare (plans)	$105 - $210	67%
Molina Healthcare 1723	$108 - $220	69%
Aetna	$113 - $590	72%
Mvp 2900	$162 - $431	103%
Cigna	$162	103%
Independent Health 5156	$210	134%

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 $136.
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 Jones 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.