CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: St John's Episcopal Hospital at South Shore

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $39
Cash Discount Price: $240
vs. Medicare Baseline: 0.31x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at St John's Episcopal Hospital at South Shore is $39. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $240. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.31x the Medicare baseline. Located in 327 Beach 19Th Street, Far Rockaway, NY.

Cash / Self-Pay

$240

Average discount available for prompt cash payment at this facility.

Insurance Median

$39

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: $240 (190%)

Insurance Median: $39 (31%)

Cash: $240 (190% of Medicare)

Ins. Median: $39 (31% 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
Healthfirst	$35 - $87	28%
Vns	$37 - $39	29%
Aetna	$39 - $48	31%
Blue Cross Blue Shield	$39 - $58	31%
Centerlight	$39	31%
Centers Plan For Healthy Living	$39	31%
Elderplan	$39	31%
Emblem Health	$39	31%
Fidelis	$39	31%
Hamaspik	$39	31%
Humana	$39	31%
Longevity	$39	31%
Lucida	$39	31%
Metroplus	$39	31%
UnitedHealthcare	$39 - $58	31%
Village Care Max	$39	31%
Wellcare	$39	31%
Magnacare	$43	34%
Molina	$43	34%
1199 National Benefit Fund	$118	93%

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 $240.
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 St John's Episcopal Hospital at South Shore 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.