CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Ira Davenport Memorial Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $703
Cash Discount Price: $1,042
vs. Medicare Baseline: 4.48x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Ira Davenport Memorial Hospital is $703. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,042. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 4.48x the Medicare baseline. Located in 7571 State Route 54, Bath, NY.

Cash / Self-Pay

$1,042

Average discount available for prompt cash payment at this facility.

Insurance Median

$703

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%)

Cash / Self-Pay: $1,042 (664%)

Insurance Median: $703 (448%)

Cash: $1,042 (664% of Medicare)

Ins. Median: $703 (448% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 448% of the Medicare baseline (a markup of 348%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Empire	$36 - $143	23%
Blue Cross Blue Shield	$121 - $3,584	77%
Humana	$147 - $1,063	94%
Tricare	$147	94%
Amerihealth Caritas Mcr Adv - All Plans	$149	95%
Fidelis	$224	143%
UnitedHealthcare	$526 - $1,240	335%
Fidelis Care - Exchange - All Plans	$573 - $650	365%
Geisinger - All Plans	$606 - $687	386%
Cigna	$649 - $736	413%
Mvp Health Plan - All Plans	$649 - $736	413%
Independent Health - All Plans	$677 - $768	431%
Upmc - All Plans	$719 - $815	458%
Pomco Inc - All Plans	$750 - $851	478%
Aetna	$781 - $1,054	498%
Emblem Health - All Plans	$917 - $1,040	584%
Martins Point - All Plans	$1,042 - $1,181	664%
Emblem/Ghi	$1,092	696%
Healthnow - All Plans	$3,432 - $3,891	2186%

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 $1,042.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77066.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Ira Davenport Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77066.
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.