CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Penn State Health St. Joseph

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $95
Cash Discount Price: $140
vs. Medicare Baseline: 0.75x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Penn State Health St. Joseph is $95. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $140. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.75x the Medicare baseline. Located in 2500 Bernville Road, Reading, PA.

Cash / Self-Pay

$140

Average discount available for prompt cash payment at this facility.

Insurance Median

$95

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: $140 (111%)

Insurance Median: $95 (75%)

Cash: $140 (111% of Medicare)

Ins. Median: $95 (75% 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 Caritas]	$71 - $84	56%
[Highmark Wholecare]	$71 - $84	56%
[Geisinger]	$75 - $390	59%
[Health Partners Plans]	$78 - $85	62%
[Pa Health & Wellness]	$78 - $86	62%
[Highmark]	$83 - $316	66%
UnitedHealthcare	$84 - $366	67%
[Cbc]	$84 - $285	67%
[Ibc]	$84 - $268	67%
Aetna	$85 - $276	67%
Humana	$85	67%
[Healthspring]	$85	67%
[Upmc]	$85 - $399	67%
[Point Comfort Underwriters]	$105	83%
[Highmark Choice Blue]	$253	200%
[Highmark Aca]	$266	211%
Cigna	$331	262%
[Preferred Healthcare Systems]	$405	321%
[First Health]	$432	342%
[Multiplan]	$432	342%

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 $140.
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 Penn State Health St. Joseph 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.