CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: West Penn Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $110
Cash Discount Price: $366
vs. Medicare Baseline: 0.87x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at West Penn Hospital is $110. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $366. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.87x the Medicare baseline. Located in 4800 Friendship Avenue, Pittsburgh, PA.

Cash / Self-Pay

$366

Average discount available for prompt cash payment at this facility.

Insurance Median

$110

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: $366 (290%)

Insurance Median: $110 (87%)

Cash: $366 (290% of Medicare)

Ins. Median: $110 (87% 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
Amerihealth	$31 - $173	25%
Pennsylvania Health And Wellness	$39 - $157	31%
Highmark	$40 - $153	32%
Geisinger	$43 - $168	34%
UnitedHealthcare	$43 - $252	34%
Cigna	$57 - $198	45%
American Health Plans	$83	66%
Life Pittsburgh	$83	66%
Martin'S Point	$83 - $257	66%
University Of Pittsburgh Medical Center	$83 - $115	66%
Aetna	$86 - $275	68%
Medicare (plans)	$86	68%
Highmark Wholecare	$88 - $144	70%
Humana	$88	70%
Molina	$91	72%
Medical Mutual	$152	120%

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 $366.
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 West Penn Hospital 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.