CMS Price Transparency Data
Diagnostic mammogram (both breasts)
Facility: Saint Alphonsus Medical Center Ontario
Billing Code: 77066 (CPT)
Factual Cost Summary (Answer Capsule)
- CPT Billing Code: 77066
- Insurance Median: $161
- Cash Discount Price: $348
- vs. Medicare Baseline: 1.03x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Saint Alphonsus Medical Center Ontario is $161. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $348. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.03x the Medicare baseline. Located in 351 Sw 9Th Street, Ontario, OR.
Cash / Self-Pay
$348
Average discount available for prompt cash payment at this facility.
Insurance Median
$161
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: $348 (222%)
Insurance Median: $161 (103%)
Cash: $348 (222% of Medicare)
Ins. Median: $161 (103% 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.
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Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Blue Cross Blue Shield | $108 - $456 | 69% |
| Medicare (plans) | $108 - $115 | 69% |
| UnitedHealthcare | $108 - $515 | 69% |
| Aetna | $111 - $508 | 71% |
| American Health Advantage Of Idaho | $112 | 71% |
| Medicaid / KanCare | $122 - $161 | 78% |
| Ada County Jail Inmate Ins | $161 | 103% |
| Ambetter / Centene | $161 | 103% |
| Amish Mennonite | $161 | 103% |
| Bcccp-Michigan | $161 | 103% |
| Bccp | $161 | 103% |
| Bmc Healthnet | $161 | 103% |
| Breast Grant-Connecticut | $161 | 103% |
| California Health And Wellness | $161 | 103% |
| Cardinal Innovations Lme | $161 | 103% |
| Care Oregon Ohp | $161 | 103% |
| Cencal Health Plan | $161 | 103% |
| Cenpatico | $161 | 103% |
| Centurion Of Idaho | $161 | 103% |
| Chhuny | $161 | 103% |
| Childrens Comm Health Plan | $161 | 103% |
| Childrens Medical Services Title 19 | $161 | 103% |
| Cigna | $161 - $504 | 103% |
| Community Benefit Health | $161 | 103% |
| Community Care Behavorial Health | $161 | 103% |
| Community Health Choice | $161 | 103% |
| Covid19 Hrsa Uninsured Testing And Treatment Fund | $161 | 103% |
| Dean Wi Badgercare | $161 | 103% |
| Delaware First Health | $161 | 103% |
| Delta Dental Nj | $161 | 103% |
| Dph Tb Program | $161 | 103% |
| Dscc | $161 | 103% |
| Eastpointe Lme | $161 | 103% |
| Family Health Network | $161 | 103% |
| Freedom First Healthcare | $161 | 103% |
| Ghc Scw Wi Badgercare | $161 | 103% |
| Harbor Health | $161 | 103% |
| Health Safety Net | $161 | 103% |
| Healthy Blue Ne | $161 | 103% |
| Hennepin Health | $161 | 103% |
| Humana | $161 - $472 | 103% |
| Id County Ada | $161 | 103% |
| Id County Canyon | $161 | 103% |
| Id County Cat Fund | $161 | 103% |
| Id County Payette | $161 | 103% |
| Idaho Womens Health Check | $161 | 103% |
| Indiana Breast Cervical Cancer | $161 | 103% |
| Inland Empire Health Plan | $161 | 103% |
| Intercommunity Health Ohp | $161 | 103% |
| Iowa Total Care | $161 | 103% |
| Jai Medical System | $161 | 103% |
| Kern Family Health Plan | $161 | 103% |
| Keystone First | $161 | 103% |
| Keystone First Chip | $161 | 103% |
| La Care Health Plan | $161 | 103% |
| Lakeland Care Inc | $161 | 103% |
| Managed Health Services - Indiana | $161 | 103% |
| Maryland Breast & Cervical Program | $161 | 103% |
| Maryland Healthy Smiles - Scion Dental | $161 | 103% |
| Maryland Physicians Care | $161 | 103% |
| Massachusetts Behavioral Health Partnership | $161 | 103% |
| Mdwise | $161 | 103% |
| Medi-Cal | $161 | 103% |
| Medi-Cal Healthnet | $161 | 103% |
| Medstar Dc Healthy Family | $161 | 103% |
| Medstar Md Health Choice | $161 | 103% |
| Mo Home State Health Plan | $161 | 103% |
| Molina Centennial Care | $161 | 103% |
| Nascentia Health Options | $161 | 103% |
| Nebraska Total Care | $161 | 103% |
| New York Cancer Services Program | $161 | 103% |
| Nextlevel Health | $161 | 103% |
| Oregon Screenwise | $161 | 103% |
| Pace Of Southwest Michigan | $161 | 103% |
| Paramount Advantage | $161 | 103% |
| Parkland Community Health Plan | $161 | 103% |
| Partners Behavioral Lme | $161 | 103% |
| Peach State Healthplan | $161 | 103% |
| Presbyterian Centennial Care | $161 | 103% |
| Prestige Health Choice | $161 | 103% |
| Priority Partners | $161 | 103% |
| Rx 340B Pass Along | $161 | 103% |
| Rx Assistance/Rx Manufacturer Assistance 0 Copay | $161 | 103% |
| Rx Medi-Cal | $161 | 103% |
| Rx Meridian Rx | $161 | 103% |
| Sandhills Center Lme | $161 | 103% |
| Screening For Life | $161 | 103% |
| Sunshine State Health Plan | $161 | 103% |
| Superior Health | $161 | 103% |
| Tenncare | $161 | 103% |
| Texas Children'S Health Plan | $161 | 103% |
| Trillium Community Ohp | $161 | 103% |
| Tufts Health Public Plans | $161 | 103% |
| Vaya Health Lme | $161 | 103% |
| Wellsense Health Plan | $161 | 103% |
| Wi Womens Wellness | $161 | 103% |
| Blue Benefit Administrators Of Massachusetts | $176 | 112% |
| Blue Care Network | $176 | 112% |
| Blue Distinction Transplant | $176 | 112% |
| Blue Shield - Ca | $176 | 112% |
| Blue Shield - Id (Regence) | $176 | 112% |
| Blue Shield - Ny Highmark Northeastern | $176 | 112% |
| Blue Shield - Ny Highmark Western | $176 | 112% |
| Blue Shield - Pa (Highmark) | $176 | 112% |
| Blue Shield - Wa (Regence) | $176 | 112% |
| Healthcare Management Admin | $189 | 120% |
| Moda Health | $197 - $520 | 125% |
| Selecthealth | $248 - $482 | 158% |
| Webtpa | $290 - $482 | 185% |
| Mountain Health Co-Op | $322 | 205% |
| Pacificsource Health Plans | $322 - $504 | 205% |
| Allegiance | $407 | 259% |
| Correctional Health Partners | $418 | 266% |
| Columbia Health Network | $429 | 273% |
| Healthnet | $450 | 287% |
| Allied National Global Care | $482 | 307% |
| Asrm - Reliance Standard Life Insurance | $482 | 307% |
| Christian Care Ministry | $482 | 307% |
| Dean Health | $482 | 307% |
| Fallon Health | $482 | 307% |
| Family Life Insurance Company | $482 | 307% |
| First Choice Health | $482 | 307% |
| Ghc Scw | $482 | 307% |
| International Benefit Administrators | $482 | 307% |
| Lifetime Benefit Solutions | $482 | 307% |
| Manhattan Life | $482 | 307% |
| Pai | $482 | 307% |
| Pan-American Life | $482 | 307% |
| Paramount Hmo | $482 | 307% |
| Phcs | $482 | 307% |
| Trinity Health Share | $482 | 307% |
| Lifewise | $498 | 317% |
| Priority Health | $504 | 321% |
| Allied Benefit Systems | $508 | 324% |
| Ameriben | $508 | 324% |
| Asr Health Benefits | $508 | 324% |
| Christian Brother Services | $508 | 324% |
| Geha | $508 - $515 | 324% |
| Healthez | $508 | 324% |
| Luminare Health (Detroit) | $508 | 324% |
| Rural Carrier Health Benefit Plan | $508 | 324% |
| First Health | $509 | 324% |
| Medi Share | $509 | 324% |
| Providence | $509 | 324% |