CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Reading Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $277
Cash Discount Price: $485
vs. Medicare Baseline: 2.19x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Reading Hospital is $277. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $485. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.19x the Medicare baseline. Located in 420 S 5Th Avenue, West Reading, PA.

Cash / Self-Pay

$485

Average discount available for prompt cash payment at this facility.

Insurance Median

$277

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: $485 (384%)

Insurance Median: $277 (219%)

Cash: $485 (384% of Medicare)

Ins. Median: $277 (219% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 219% of the Medicare baseline (a markup of 119%). 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
Blue Cross Blue Shield	$66 - $776	52%
Upmc	$83 - $374	66%
Geisinger	$90 - $439	71%
Keystone First	$90	71%
Pa Health & Wellness	$94	74%
UnitedHealthcare	$94 - $454	74%
Amerihealth Caritas	$96	76%
Gateway	$96	76%
Health Partners	$96	76%
Wernersville State Hospital	$98	78%
Aetna	$188 - $478	149%
Pma	$277	219%
Lehigh Valley Health Network	$312	247%
Cigna	$396	314%
Berkshire	$520	412%
First Health	$534	423%
Blue Ridge	$658	521%

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 $485.
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 Reading Hospital 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.