CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Maimonides Medical Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $40
Cash Discount Price: $367
vs. Medicare Baseline: 0.32x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Maimonides Medical Center is $40. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $367. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.32x the Medicare baseline. Located in 4802 Tenth Avenue, Brooklyn, NY.

Cash / Self-Pay

$367

Average discount available for prompt cash payment at this facility.

Insurance Median

$40

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: $367 (291%)

Insurance Median: $40 (32%)

Cash: $367 (291% of Medicare)

Ins. Median: $40 (32% 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
Aetna	$14 - $100	11%
UnitedHealthcare	$14 - $152	11%
Emblem Health - Hip	$16 - $100	13%
United Community Plan	$17 - $110	13%
Fidelis	$19 - $40	15%
Blue Cross Blue Shield	$22 - $100	17%
Healthfirst	$28 - $98	22%
Metroplus	$32 - $120	25%
Villagecare Maxx Fida	$33 - $40	26%
Cigna	$34 - $226	27%
Visiting Nurse Svc Of Ny	$34 - $38	27%
Emblem Health - Hip Vip	$39	31%
Wellcare	$39	31%
Centers Plan For Healthy Living	$40	32%
Elderplan	$40	32%
Emblem Health - Ghi	$40 - $304	32%
Molina	$40 - $86	32%
Hamaspik	$42	33%
Local 1199	$42 - $118	33%
Mvp Health	$44	35%
Magnacare	$49 - $51	39%
Oxford Health Plan	$54 - $152	43%
Oxford Liberty	$55 - $152	44%

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 $367.
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 Maimonides Medical Center 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.