CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: NYU Langone Hospitals

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $524
Cash Discount Price: $283
vs. Medicare Baseline: 4.15x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at NYU Langone Hospitals is $524. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $283. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 4.15x the Medicare baseline. Located in 550 First Avenue, New York, NY.

Cash / Self-Pay

$283

Average discount available for prompt cash payment at this facility.

Insurance Median

$524

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: $283 (224%)

Insurance Median: $524 (415%)

Cash: $283 (224% of Medicare)

Ins. Median: $524 (415% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 415% of the Medicare baseline (a markup of 315%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Fidelis	$97 - $388	77%
Healthfirst	$97 - $235	77%
Healthplus	$97 - $388	77%
1199	$118	93%
Hip	$129 - $8,427	102%
Medicaid / KanCare	$129 - $173	102%
Metroplus	$129 - $388	102%
UnitedHealthcare	$129 - $721	102%
Somos	$135 - $233	107%
Ghi	$144 - $12,574	114%
Medicare (plans)	$144 - $147	114%
Wellcare	$144 - $147	114%
Centerlight	$146 - $150	116%
Amida	$187 - $190	148%
Hamaspik	$215 - $221	170%
Oscar	$319	253%
Oxford	$385 - $497	305%
Aetna	$524 - $1,490	415%
Blue Cross Blue Shield	$775 - $969	614%
Multiplan	$1,162	920%
Cigna	$6,487	5138%
Magnacare	$13,453 - $25,798	10656%

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 $283.
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 NYU Langone Hospitals 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.