CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Lancaster General Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $320
  • Cash Discount Price: $785
  • vs. Medicare Baseline: 2.53x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Lancaster General Hospital is $320. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $785. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.53x the Medicare baseline. Located in 555 North Duke Street, Lancaster, PA.
Cash / Self-Pay
$785

Average discount available for prompt cash payment at this facility.

Insurance Median
$320

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: $785 (622%)
Insurance Median: $320 (253%)
Cash: $785 (622% of Medicare)
Ins. Median: $320 (253% 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 253% of the Medicare baseline (a markup of 153%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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 $41 - $816 32%
Aetna $42 - $552 33%
Albright Life $42 - $83 33%
Amerihealth Caritas $42 - $85 33%
Blue Cross Blue Shield $42 - $746 33%
Coatesville Va $42 - $83 33%
Hospice Generic $42 - $83 33%
Lebanon Veterans Hospital $42 - $83 33%
Medicare (plans) $42 - $91 33%
UnitedHealthcare $42 - $694 33%
Cigna $43 - $616 34%
Health Partners Mcr Advantage $43 - $86 34%
Devoted Health $44 - $87 35%
Pa Health And Wellness Mcr $44 - $87 35%
Elap Employees $59 - $118 47%
Medicaid / KanCare $75 - $162 59%
Tricare $75 59%
Oscar Health Plan $81 - $162 64%
Gateway $88 70%
Claim Watcher Plus $125 - $249 99%
Claim Watcher $137 - $274 109%
Hospice And Community Care $149 - $155 118%
Elap Other Groups $151 - $302 120%
Upmc For You $156 124%
Old Order Group $212 - $261 168%
Lg Coresource/Lg Eliance $224 - $233 177%
Lancashire Hall $236 - $816 187%
Nursing Home Op Services $236 - $245 187%
Affilia Home Health $314 - $816 249%
Masonic Homes $330 - $816 261%
Eliance Health Solutions $502 - $522 398%
Highmark Commercial Preferred $525 - $816 416%
Ehp $644 - $669 510%
Upmc Commercial $644 - $694 510%
Devon $667 - $694 528%
Geisinger Commercial $667 - $694 528%
Intergroup Services $667 - $694 528%
Preferred Healthcare $667 - $694 528%
Medi-Share Christian Care $746 - $775 591%
Commercial Generic $785 - $816 622%
Highmark Commercial Non-Preferred $785 - $823 622%
Magellan $785 - $816 622%
United Behavioral Health $785 - $816 622%
Value Options $785 - $816 622%
Workers Compensation $785 - $816 622%
Gift Of Life Donor Program $13,500 10693%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 555 North Duke Street, Lancaster, PA 17602
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals