CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Saratoga Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $111
Cash Discount Price: $153
vs. Medicare Baseline: 0.88x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Saratoga Hospital is $111. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $153. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.88x the Medicare baseline. Located in 211 Church Street, Saratoga Springs, NY.

Cash / Self-Pay

$153

Average discount available for prompt cash payment at this facility.

Insurance Median

$111

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: $153 (121%)

Insurance Median: $111 (88%)

Cash: $153 (121% of Medicare)

Ins. Median: $111 (88% 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 - $356	18%
Blue Cross Blue Shield	$24 - $477	19%
Fidelis	$26 - $356	21%
Medicare (plans)	$26 - $119	21%
Tricare	$29 - $119	23%
Hamaspik	$32 - $372	25%
Emblem Health Ghi	$34 - $131	27%
Mvp	$34 - $227	27%
UnitedHealthcare	$34 - $716	27%
Aetna	$35 - $390	28%
Blue Shield Highmark	$38 - $372	30%
Medicaid / KanCare	$38 - $116	30%
Cigna	$54 - $227	43%
Mvp Commercial	$99 - $556	78%
Blue Shield	$124 - $432	98%
Mvp Essential Plan	$158 - $317	125%
Mvp Govt Programs	$158	125%
Emblem	$169 - $188	134%
Empire Plan Nyship	$178 - $556	141%
Nascentia Health Options	$183	145%
Multiplan	$191 - $676	151%
Magnacare	$230 - $755	182%

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 $153.
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 Saratoga 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.