CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: UPMC Altoona

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $288
Cash Discount Price: $345
vs. Medicare Baseline: 2.28x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at UPMC Altoona is $288. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $345. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.28x the Medicare baseline. Located in 620 Howard Avenue, Altoona, PA.

Cash / Self-Pay

$345

Average discount available for prompt cash payment at this facility.

Insurance Median

$288

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: $345 (273%)

Insurance Median: $288 (228%)

Cash: $345 (273% of Medicare)

Ins. Median: $288 (228% 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 228% of the Medicare baseline (a markup of 128%). 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	$61	48%
Aetna	$75 - $305	59%
UnitedHealthcare	$79 - $295	63%
Upmc Health Plan	$83 - $601	66%
Geisinger	$104 - $316	82%
Highmark Wholecare (Prev Gateway)	$111 - $288	88%
Health Partners Plans (Jefferson Health Plan)	$113	90%
Amerihealth Caritas	$117	93%
Pa Health & Wellness	$128	101%
Cigna	$288	228%
Preferred Healthcare System	$288	228%
Private Health Care Systems	$460	364%

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 $345.
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 Altoona 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.