CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: UPMC Carlisle

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $242
Cash Discount Price: $310
vs. Medicare Baseline: 1.54x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at UPMC Carlisle is $242. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $310. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.54x the Medicare baseline. Located in 361 Alexander Spring Road, Carlisle, PA.

Cash / Self-Pay

$310

Average discount available for prompt cash payment at this facility.

Insurance Median

$242

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: $310 (197%)

Insurance Median: $242 (154%)

Cash: $310 (197% of Medicare)

Ins. Median: $242 (154% 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
Prime Net	$71 - $391	45%
Aetna	$85 - $253	54%
Blue Cross Blue Shield	$103 - $283	66%
Keystone Health Plan	$103 - $283	66%
UnitedHealthcare	$119 - $381	76%
Amerihealth Caritas	$165	105%
Highmark Wholecare (Prev Gateway)	$165	105%
Upmc Health Plan	$169 - $675	108%
Health Partners Plans (Jefferson Health Plan)	$177	113%
Geisinger	$189 - $373	120%
Pa Health & Wellness	$221	141%
Wellspan Population Health	$336 - $414	214%
Multiplan	$439	280%
Cigna	$611	389%

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 $310.
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 UPMC Carlisle 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.