CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: St Catherine of Siena Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $249
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.97x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at St Catherine of Siena Hospital is $249. 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 $126.25, this hospital’s rate is 1.97x the Medicare baseline. Located in 50 Route 25A, Smithtown, NY.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$249

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%)
Insurance Median: $249 (197%)
Ins. Median: $249 (197% 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.

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 78%
Beacon Health Options $98 - $392 78%
Beacon Health Strategies $98 - $314 78%
Centerlight Healthcare $98 78%
Elderplan Inc. $98 78%
Emblem Health $98 - $392 78%
Fidelis Care New York $98 - $220 78%
Health First $98 - $220 78%
Health Plus $98 - $220 78%
Independent Health $98 78%
Medicaid / KanCare $98 78%
Mvp Health Plans $98 - $392 78%
Senior Whole Health $98 78%
UnitedHealthcare $98 - $367 78%
Self Pay $100 79%
Us Family Health Plan $181 143%
Aetna $209 - $392 166%
Surest $217 172%
Centers Plan For Healthy Living $236 187%
Zadroga $237 188%
Mail Handlers Benefit Plan $249 197%
Meritain Health $249 197%
Nippon Life Insurance Company Of America $249 197%
Salvation Army $249 197%
Blue Cross Blue Shield $278 - $392 220%
Liberty Health $314 249%
Oscar Health $322 255%
American Plan Administrators $353 280%
Amerihealth Administrators $353 280%
Benefit Services $353 280%
Ghi Cbp Ny City Employee Alternate $353 280%
International Benefit Administrator $353 280%
Ultra Benefits Inc. $353 280%
Centivo $372 - $392 295%
Apwu $392 310%
Cigna $392 - $510 310%
Daniel H Cook $392 310%
Nalc $392 310%
Samba $392 310%
Local 1199 $472 374%
Allied Wellfare Fund $510 404%
American Group Administrators $510 404%
Bakery & Confectionery Union $510 404%
Comprehensive Benefits Consultant $510 404%
Guardian Life Insurance Company Of America $510 404%
Maloney And Assoc $510 404%
Multiplan $510 404%
Performax $510 404%
Phcs $510 404%
Pomco $510 404%
Tpa Inc $510 404%
Unicare $510 404%
United Employees Health Plan $510 404%
Brighton $535 - $722 424%
Coventry $581 - $628 460%
Longevity Health Plan $628 497%
Magellan $628 497%
Galaxy $706 559%
Three Rivers Provider Network $706 559%
Aither Health $785 622%
Alpha Care $785 622%
Dentaquest $785 622%
Veterans Affairs $785 622%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 50 Route 25A, Smithtown, NY 11787
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals