CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Penn Presbyterian Medical Center

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $423
  • Cash Discount Price: $1,057
  • vs. Medicare Baseline: 2.69x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Penn Presbyterian Medical Center is $423. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,057. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 2.69x the Medicare baseline. Located in 51 North 39Th Street, Philadelphia, PA.
Cash / Self-Pay
$1,057

Average discount available for prompt cash payment at this facility.

Insurance Median
$423

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: $1,057 (673%)
Insurance Median: $423 (269%)
Cash: $1,057 (673% of Medicare)
Ins. Median: $423 (269% 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 269% of the Medicare baseline (a markup of 169%). 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
Blue Cross Blue Shield $87 - $1,057 55%
Keystone Hmo Proactive $87 55%
Ibc Commercial Hpn $90 57%
Medicaid / KanCare $91 - $1,057 58%
Health Partners $111 - $1,057 71%
Tricare $114 73%
Us Family Health Plan $114 73%
Medicare (plans) $115 - $117 73%
Philadelphia Va Medical Center $115 73%
Upmc $115 - $1,057 73%
Keystone Mercy Health Plan $116 - $1,057 74%
Ibc $117 75%
Cigna $119 - $310 76%
Geisinger Health Plan $119 - $365 76%
Humana $119 - $846 76%
Pa Health And Wellness $121 - $190 77%
Penn Life (Living Independently For Elders) $121 77%
Aetna $122 - $1,057 78%
UnitedHealthcare $122 - $1,057 78%
Clover Health Plan $124 79%
Keystone First $128 82%
Pa Medical Assistance $130 83%
Gateway Health Plan $143 91%
Elap $164 104%
Horizon Nj Health $179 - $186 114%
Claims Watcher $184 - $207 117%
Oscar Health Plan $196 125%
Centivo $207 132%
Elap Services $214 136%
Highmark $242 154%
Pgm - Regie De L'Assurance Maladie Quebec $243 155%
Preferred Health Care Eliance $264 168%
Penn Global Medicine $305 194%
Pgm - Kuwait Defense $370 - $476 236%
Devon $402 - $476 256%
Qualcare $402 256%
Coventry $423 - $539 269%
Pgm - Chop $423 269%
Wissahickon Hospice $423 269%
Healthamerica/Coventry $476 - $518 303%
Olympus $501 319%
First Health Global $528 336%
Urn-Cancer Resource Services $528 336%
Health Net $634 404%
Pgm - Royal Embassy Of Saudi Arabia $634 404%
Pgm - Embassy Of Qatar $687 438%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $687 438%
Pgm - Embassy Of The United Emirates/Ipc $740 471%
Devon Health Services Inc $846 539%
Health America/Ccn $846 539%
Intergroup $846 539%
Pgm - Kuwait Health Division $846 539%
Pgm - Kuwait Oil $846 539%
Preferred Care $846 539%
Commercial Other $1,057 673%
International Pfs $1,057 673%
Magellan $1,057 673%
Quest Behavioral Health $1,057 673%
United Behavioral Health $1,057 673%
Workers Compensation $1,057 673%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 51 North 39Th Street, Philadelphia, PA 19104
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Other
  • Hospital Type: Acute Care Hospitals