CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: UPMC Memorial

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $209
Cash Discount Price: $257
vs. Medicare Baseline: 1.66x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at UPMC Memorial is $209. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $257. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.66x the Medicare baseline. Located in 1701 Innovation Drive, York, PA.

Cash / Self-Pay

$257

Average discount available for prompt cash payment at this facility.

Insurance Median

$209

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: $257 (204%)

Insurance Median: $209 (166%)

Cash: $257 (204% of Medicare)

Ins. Median: $209 (166% 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
Blue Cross Blue Shield	$50 - $613	40%
Prime Net	$71 - $320	56%
Keystone Health Plan	$86 - $613	68%
UnitedHealthcare	$98 - $316	78%
Aetna	$112 - $244	89%
Amerihealth Caritas	$133	105%
Highmark Wholecare (Prev Gateway)	$133	105%
Upmc Health Plan	$136 - $551	108%
Health Partners Plans (Jefferson Health Plan)	$143	113%
Geisinger	$153 - $310	121%
Wellspan Population Health	$300	238%
Multiplan	$365	289%
Cigna	$507	402%

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 $257.
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 Memorial 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.