CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: St Charles Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $301
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.92x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at St Charles Hospital is $301. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.92x the Medicare baseline. Located in 200 Belle Terre Road, Port Jefferson, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$301

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%)
Insurance Median: $301 (192%)
Ins. Median: $301 (192% 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.

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
Affinity Health Plan $98 - $220 62%
Beacon Health Options $98 - $423 62%
Beacon Health Strategies $98 - $338 62%
Centerlight Healthcare $98 62%
Elderplan Inc. $98 62%
Emblem Health $98 - $423 62%
Fidelis Care New York $98 - $220 62%
Health First $98 - $220 62%
Health Plus $98 - $220 62%
Independent Health $98 62%
Medicaid / KanCare $98 62%
Mvp Health Plans $98 - $423 62%
Senior Whole Health $98 62%
UnitedHealthcare $98 - $443 62%
Self Pay $100 64%
Us Family Health Plan $195 124%
Aetna $253 - $423 161%
Centers Plan For Healthy Living $254 162%
Surest $263 168%
Zadroga $292 186%
Mail Handlers Benefit Plan $301 192%
Meritain Health $301 192%
Nippon Life Insurance Company Of America $301 192%
Salvation Army $301 192%
Blue Cross Blue Shield $337 - $443 215%
Liberty Health $338 215%
Oscar Health $347 221%
American Plan Administrators $381 243%
Amerihealth Administrators $381 243%
Benefit Services $381 243%
Ghi Cbp Ny City Employee Alternate $381 243%
International Benefit Administrator $381 243%
Ultra Benefits Inc. $381 243%
Apwu $423 269%
Brighton $423 - $637 269%
Centivo $423 - $461 269%
Cigna $423 - $550 269%
Daniel H Cook $423 269%
Nalc $423 269%
Samba $423 269%
Allied Wellfare Fund $550 350%
American Group Administrators $550 350%
Bakery & Confectionery Union $550 350%
Comprehensive Benefits Consultant $550 350%
Guardian Life Insurance Company Of America $550 350%
Maloney And Assoc $550 350%
Multiplan $550 350%
Performax $550 350%
Phcs $550 350%
Pomco $550 350%
Tpa Inc $550 350%
Unicare $550 350%
United Employees Health Plan $550 350%
Local 1199 $572 364%
Coventry $626 - $719 399%
Longevity Health Plan $677 431%
Magellan $677 431%
Galaxy $761 485%
Three Rivers Provider Network $761 485%
Aither Health $846 539%
Alpha Care $846 539%
Dentaquest $846 539%
Veterans Affairs $846 539%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 200 Belle Terre Road, Port Jefferson, NY 11777
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals