CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Hospital of Univ of Pennsylvania

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $525
  • Cash Discount Price: $2,388
  • vs. Medicare Baseline: 4.16x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Hospital of Univ of Pennsylvania is $525. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $2,388. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 4.16x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$2,388

Average discount available for prompt cash payment at this facility.

Insurance Median
$525

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: $2,388 (1891%)
Insurance Median: $525 (416%)
Cash: $2,388 (1891% of Medicare)
Ins. Median: $525 (416% 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 416% of the Medicare baseline (a markup of 316%). 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 $47 37%
Blue Cross Blue Shield $66 - $830 52%
Keystone Hmo Proactive $66 52%
Ibc Commercial Hpn $68 54%
Medicaid / KanCare $75 - $2,388 59%
Kaiser Permanente $79 - $2,388 63%
UnitedHealthcare $83 - $2,388 66%
Health Partners $89 - $2,388 70%
Medicare (plans) $94 - $96 74%
Philadelphia Va Medical Center $94 74%
Tricare $94 74%
Upmc $94 - $2,388 74%
Us Family Health Plan $94 74%
Ibc $96 76%
Keystone Mercy Health Plan $96 - $2,388 76%
Cigna $97 - $1,075 77%
Geisinger Health Plan $97 - $299 77%
Humana $97 - $1,910 77%
Devoted Health $99 78%
Pa Health And Wellness $99 - $156 78%
Penn Life (Living Independently For Elders) $99 78%
Aetna $100 - $2,388 79%
Clover Health Plan $102 81%
Keystone First $105 83%
Pa Medical Assistance $105 - $2,388 83%
Gateway Health Plan $117 93%
Elap $134 106%
Claims Watcher $151 - $170 120%
Oscar Health Plan $160 127%
Centivo $170 135%
Elap Services $176 139%
Paired Kidney Exchange $191 151%
Highmark $198 157%
Penn Global Medicine $250 198%
Horizon Nj Health $404 - $420 320%
Preferred Health Care Eliance $525 416%
Pgm - Regie De L'Assurance Maladie Quebec $549 435%
Pgm - Kuwait Defense $836 - $1,075 662%
Qualcare $907 718%
Olympus $938 743%
Coventry $955 - $1,218 756%
Pgm - Chop $955 756%
Wissahickon Hospice $955 756%
Healthamerica/Coventry $1,075 - $1,170 851%
First Health Global $1,194 946%
Health Net $1,433 1135%
Pgm - Royal Embassy Of Saudi Arabia $1,433 1135%
Pgm - Embassy Of Qatar $1,552 1229%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $1,552 1229%
Interlink $1,600 1267%
Pgm - Embassy Of The United Emirates/Ipc $1,672 1324%
Health America/Ccn $1,910 1513%
Intergroup $1,910 1513%
Pgm - Kuwait Health Division $1,910 1513%
Pgm - Kuwait Oil $1,910 1513%
Preferred Care $1,910 1513%
Blue Quality Centers For Transplant (Bqct) $2,388 1891%
City Of Philadelphia Behavioral Health $2,388 1891%
Commercial Other $2,388 1891%
International Pfs $2,388 1891%
United Behavioral Health $2,388 1891%
Workers Compensation $2,388 1891%

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