CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Lower Bucks Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $119
Cash Discount Price: $115
vs. Medicare Baseline: 0.76x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Lower Bucks Hospital is $119. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $115. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 0.76x the Medicare baseline. Located in 501 Bath Road, Bristol, PA.

Cash / Self-Pay

$115

Average discount available for prompt cash payment at this facility.

Insurance Median

$119

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: $115 (73%)

Insurance Median: $119 (76%)

Cash: $115 (73% of Medicare)

Ins. Median: $119 (76% 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
Health Partners Plan	$91 - $173	58%
Medicaid / KanCare	$91	58%
Humana	$92	59%
Keystone	$96 - $120	61%
UnitedHealthcare	$103 - $138	66%
Blue Cross Blue Shield	$115 - $211	73%
Cigna	$115	73%
Medicare (plans)	$115 - $121	73%
Pa Health & Wellness	$115 - $138	73%
Tricare	$115	73%
Provider Patners Health Plan	$119	76%
Spartan Plan Pa	$121	77%
Auto Insurance	$127	81%
Worker Compensation	$130	83%
Employer Direct Healthcare	$161	103%
Highmark	$244	155%

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 $115.
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 Lower Bucks Hospital 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.