CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Good Samaritan Hospital Medical Center

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 Good Samaritan Hospital Medical Center 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 1000 Montauk Highway, West Islip, 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%
Centerlight Healthcare $98 62%
Elderplan Inc. $98 62%
Emblem Health $98 - $370 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 - $412 62%
Senior Whole Health $98 62%
UnitedHealthcare $98 - $443 62%
Us Family Health Plan $189 120%
Centers Plan For Healthy Living $247 157%
Aetna $253 - $412 161%
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%
Liberty Health $329 210%
Blue Cross Blue Shield $337 - $443 215%
Oscar Health $337 215%
American Plan Administrators $370 236%
Amerihealth Administrators $370 236%
Benefit Services $370 236%
Ghi Cbp Ny City Employee Alternate $370 236%
International Benefit Administrator $370 236%
Ultra Benefits Inc. $370 236%
Apwu $412 262%
Centivo $412 - $461 262%
Cigna $412 - $535 262%
Daniel H Cook $412 262%
Nalc $412 262%
Samba $412 262%
Self Pay $443 282%
Brighton $448 - $625 285%
Allied Wellfare Fund $535 341%
American Group Administrators $535 341%
Bakery & Confectionery Union $535 341%
Comprehensive Benefits Consultant $535 341%
Guardian Life Insurance Company Of America $535 341%
Maloney And Assoc $535 341%
Multiplan $535 341%
Performax $535 341%
Phcs $535 341%
Pomco $535 341%
Tpa Inc $535 341%
Unicare $535 341%
United Employees Health Plan $535 341%
Local 1199 $572 364%
Coventry $609 - $700 388%
Longevity Health Plan $658 419%
Galaxy $741 472%
Three Rivers Provider Network $741 472%
Aither Health $823 524%
Alpha Care $823 524%
Dentaquest $823 524%
Veterans Affairs $823 524%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1000 Montauk Highway, West Islip, NY 11795
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals