CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Wellspan Good Samaritan Hospital

Billing Code: 77067 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$255
about 2.0× the $126 Medicare rate · typically $161–$341
modeled estimate · not a bill or quote
What this hospital charges insurers
$251
About the fair price
about $4 under the fair price · 2.0× Medicare
Medicare pays $126 Fair price $255 This hospital $251 Cash price $225 Hospital's list price $427

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

Highest price of the 9 PA hospitals we have prices for — worth calling around.

Cheapest $34 Priciest $251

Black dot = this hospital, among the 9 PA hospitals with a price for this procedure. Full list below.

A fair price for a Screening mammogram (both breasts) is about $255 (about 2.0× the $126 Medicare rate). Wellspan Good Samaritan Hospital charges insurers about $251, or about $225 in cash — about the fair price. Located in Lebanon, PA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $522 413%
Blue Cross Blue Shieldmajor $94 - $615 74%
Aetnamajor $86 - $356 68%
Cignamajor $222 176%
Geisinger $256 203%
UPMC Health Plan $256 203%
Government programs also on file: Medicare, Medicaid.
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 252 South 4Th Street, Lebanon, PA 17042
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals