CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Highland Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $187
Cash Discount Price: $587
vs. Medicare Baseline: 1.19x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Highland Hospital is $187. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $587. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.19x the Medicare baseline. Located in 1000 South Avenue, Rochester, NY.

Cash / Self-Pay

$587

Average discount available for prompt cash payment at this facility.

Insurance Median

$187

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: $587 (374%)

Insurance Median: $187 (119%)

Cash: $587 (374% of Medicare)

Ins. Median: $187 (119% 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
Medicare (plans)	$87 - $172	55%
Amerigroup (Bswny Alternate) [1720]	$98	62%
Excellus [2201]	$98	62%
Medicaid / KanCare	$98 - $317	62%
Molina Healthcare [5189], Molina Healthcare [1723]	$98	62%
UnitedHealthcare	$98 - $403	62%
Martins Point [1205]	$103 - $147	66%
Mvp [2900]	$127 - $725	81%
Humana	$131 - $171	83%
Aetna	$134 - $513	85%
Elderplan [1316]	$147	94%
Excellus Bc/Bs [2201]	$147 - $275	94%
Icircle [1728]	$147	94%
Nascentia [1729]	$147	94%
Highmark Bc/Bs Of Western Ny [5143]	$187 - $198	119%
Excellus Bc/Bs [2201], Bc/Bs Out Of Area [2401]	$212 - $511	135%
Fidelis [5155]	$216 - $333	138%
Independent Health [5156]	$250 - $302	159%
Cigna	$354 - $725	226%
Capital District Physicians Health Plan (Cdphp) [5149]	$389 - $520	248%

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 $587.
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 Highland 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.