CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Hospital of Univ of Pennsylvania

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $599
  • Cash Discount Price: $2,448
  • vs. Medicare Baseline: 3.82x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Hospital of Univ of Pennsylvania is $599. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,448. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 3.82x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$2,448

Average discount available for prompt cash payment at this facility.

Insurance Median
$599

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: $2,448 (1559%)
Insurance Median: $599 (382%)
Cash: $2,448 (1559% of Medicare)
Ins. Median: $599 (382% 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.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 382% of the Medicare baseline (a markup of 282%). 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
Gspp And Wissahickon Hospice $57 36%
Blue Cross Blue Shield $87 - $1,093 55%
Keystone Hmo Proactive $87 55%
Ibc Commercial Hpn $90 57%
Medicaid / KanCare $91 - $2,448 58%
Kaiser Permanente $95 - $2,448 61%
UnitedHealthcare $100 - $2,448 64%
Health Partners $111 - $2,448 71%
Medicare (plans) $114 - $116 73%
Philadelphia Va Medical Center $114 73%
Tricare $114 73%
Upmc $114 - $2,448 73%
Us Family Health Plan $114 73%
Ibc $116 74%
Keystone Mercy Health Plan $116 - $2,448 74%
Cigna $118 - $1,102 75%
Geisinger Health Plan $118 - $362 75%
Humana $118 - $1,958 75%
Devoted Health $120 76%
Pa Health And Wellness $120 - $188 76%
Penn Life (Living Independently For Elders) $120 76%
Aetna $121 - $2,448 77%
Clover Health Plan $123 78%
Keystone First $127 81%
Pa Medical Assistance $130 - $2,448 83%
Gateway Health Plan $142 90%
Elap $162 103%
Claims Watcher $183 - $206 117%
Oscar Health Plan $194 124%
Paired Kidney Exchange $196 125%
Centivo $206 131%
Elap Services $212 135%
Highmark $240 153%
Penn Global Medicine $303 193%
Horizon Nj Health $414 - $430 264%
Preferred Health Care Eliance $539 343%
Pgm - Regie De L'Assurance Maladie Quebec $563 359%
Pgm - Kuwait Defense $857 - $1,102 546%
Qualcare $930 592%
Olympus $962 613%
Coventry $979 - $1,248 624%
Pgm - Chop $979 624%
Wissahickon Hospice $979 624%
Healthamerica/Coventry $1,102 - $1,200 702%
First Health Global $1,224 780%
Health Net $1,469 936%
Pgm - Royal Embassy Of Saudi Arabia $1,469 936%
Pgm - Embassy Of Qatar $1,591 1014%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $1,591 1014%
Interlink $1,640 1045%
Pgm - Embassy Of The United Emirates/Ipc $1,714 1092%
Health America/Ccn $1,958 1247%
Intergroup $1,958 1247%
Pgm - Kuwait Health Division $1,958 1247%
Pgm - Kuwait Oil $1,958 1247%
Preferred Care $1,958 1247%
Blue Quality Centers For Transplant (Bqct) $2,448 1559%
City Of Philadelphia Behavioral Health $2,448 1559%
Commercial Other $2,448 1559%
International Pfs $2,448 1559%
United Behavioral Health $2,448 1559%
Workers Compensation $2,448 1559%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals