CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: The University of Vermont Health Network-Alice Hy

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $71
Cash Discount Price: $367
vs. Medicare Baseline: 0.45x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at The University of Vermont Health Network-Alice Hy is $71. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $367. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 0.45x the Medicare baseline. Located in 133 Park Street, Po Box 729, Malone, NY.

Cash / Self-Pay

$367

Average discount available for prompt cash payment at this facility.

Insurance Median

$71

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: $367 (234%)

Insurance Median: $71 (45%)

Cash: $367 (234% of Medicare)

Ins. Median: $71 (45% 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.

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
Capital District Physicians' Health Plan	$30 - $634	19%
UnitedHealthcare	$31 - $665	20%
Fidelis Care	$38 - $216	24%
Humana	$38 - $216	24%
Mvp	$38 - $216	24%
Aetna	$44 - $580	28%
Martins Point	$44 - $216	28%
Veterans Affairs Community Care Network	$44 - $216	28%
Choicecare	$47 - $506	30%
Magnacare	$47 - $540	30%
Blue Cross Blue Shield	$48 - $557	31%
Highmark Blueshield	$58 - $605	37%
St. Regis	$107 - $216	68%

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 $367.
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 The University of Vermont Health Network-Alice Hy 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.