CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Clarion Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $177
  • Cash Discount Price: $291
  • vs. Medicare Baseline: 1.13x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Clarion Hospital is $177. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $291. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 1.13x the Medicare baseline. Located in One Hospital Drive, Clarion, PA.
Cash / Self-Pay
$291

Average discount available for prompt cash payment at this facility.

Insurance Median
$177

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: $291 (185%)
Insurance Median: $177 (113%)
Cash: $291 (185% of Medicare)
Ins. Median: $177 (113% 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.

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
Highmark $99 - $177 63%
Amerihealth $100 - $143 64%
Cigna $100 - $260 64%
Highmark Community Blue $100 64%
Martin'S Point - Usfhp $100 - $182 64%
Medicare (plans) $100 64%
Tricare $100 64%
UnitedHealthcare $100 64%
Aetna $103 - $463 66%
Geisinger $105 - $156 67%
Devoted Health Plan $106 - $208 68%
The Health Plan $106 - $236 68%
Gateway $107 - $192 68%
Pa Health & Wellness $107 68%
American Health Plan $110 70%
Upmc $112 - $530 71%
Medicaid / KanCare $130 83%
Jefferson Health Plan $143 91%
Highmark - Ind.& Managed Care $177 - $226 113%
Peak Health $236 - $364 150%
Devon $390 248%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: One Hospital Drive, Clarion, PA 16214
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals