CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Glens Falls Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $101
Cash Discount Price: $102
vs. Medicare Baseline: 0.80x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Glens Falls Hospital is $101. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $102. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.80x the Medicare baseline. Located in 100 Park Street, Glens Falls, NY.

Cash / Self-Pay

$102

Average discount available for prompt cash payment at this facility.

Insurance Median

$101

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: $102 (81%)

Insurance Median: $101 (80%)

Cash: $102 (81% of Medicare)

Ins. Median: $101 (80% 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.

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
Cdphp	$23 - $369	18%
Blue Cross Blue Shield	$24 - $248	19%
Medicare (plans)	$26 - $119	21%
UnitedHealthcare	$26 - $324	21%
Emblem Health Ghi	$29 - $119	23%
Tricare	$29 - $119	23%
Aetna	$34 - $158	27%
Fidelis	$34 - $369	27%
Mvp	$34 - $345	27%
Blue Shield Highmark	$38 - $372	30%
Medicaid / KanCare	$38 - $116	30%
Hamaspik	$44 - $248	35%
Nascentia Health Options	$44 - $248	35%
Magnacare	$51 - $286	40%
Cigna	$54 - $227	43%
Emblem	$54 - $305	43%
Empire Plan Nyship	$58 - $324	46%
Multiplan	$58 - $324	46%
Mvp Commercial	$68 - $381	54%
Blue Shield	$107 - $380	85%

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 $102.
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 Glens Falls Hospital 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.