CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: UPMC Hamot

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $137
Cash Discount Price: $205
vs. Medicare Baseline: 1.09x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at UPMC Hamot is $137. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $205. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.09x the Medicare baseline. Located in 201 State Street, Erie, PA.

Cash / Self-Pay

$205

Average discount available for prompt cash payment at this facility.

Insurance Median

$137

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: $205 (162%)

Insurance Median: $137 (109%)

Cash: $205 (162% of Medicare)

Ins. Median: $137 (109% 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.

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
Univera	$51 - $150	40%
Blue Cross Blue Shield	$61 - $295	48%
Aetna	$86 - $239	68%
Cigna	$103 - $137	82%
Independent Health	$105 - $111	83%
Upmc Health Plan	$115 - $275	91%
UnitedHealthcare	$120 - $136	95%
Geisinger	$146	116%
Highmark Wholecare (Prev Gateway)	$155 - $171	123%
Health Partners Plans (Jefferson Health Plan)	$158	125%
Amerihealth Caritas	$163	129%
Pa Health & Wellness	$178	141%
Intergroup	$222 - $274	176%
Multiplan	$239 - $274	189%

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 $205.
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 UPMC Hamot 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.