CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Punxsutawney Area Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $82
Cash Discount Price: $156
vs. Medicare Baseline: 0.65x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Punxsutawney Area Hospital is $82. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $156. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.65x the Medicare baseline. Located in 81 Hillcrest Drive, Punxsutawney, PA.

Cash / Self-Pay

$156

Average discount available for prompt cash payment at this facility.

Insurance Median

$82

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: $156 (124%)

Insurance Median: $82 (65%)

Cash: $156 (124% of Medicare)

Ins. Median: $82 (65% 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
Highmark Wholecare	$21 - $118	17%
UnitedHealthcare	$24 - $310	19%
Upmc Health Plan	$29 - $486	23%
Tricare	$31 - $106	25%
Aetna	$34 - $251	27%
Amerihealth Caritas	$34 - $116	27%
Geisinger Health Plan	$34 - $118	27%
Highmark	$34 - $223	27%
United Mine Workers Of America	$34 - $118	27%
Cigna	$35 - $461	28%
Ambetter / Centene	$36 - $124	29%
Humana	$41 - $82	32%
Pa Health And Wellness Commercial	$43 - $167	34%
Geisinger	$48 - $234	38%
Pa Workers Compensation	$82 - $776	65%

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 $156.
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 Punxsutawney Area Hospital 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.