CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Penn Presbyterian Medical Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $423
  • Cash Discount Price: $1,057
  • vs. Medicare Baseline: 3.35x Medicare
The contracted insurance negotiated median rate for a Screening 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 $126.25, this hospital’s rate is 3.35x 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
$126.25

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $126.25 (100%)
Cash / Self-Pay: $1,057 (837%)
Insurance Median: $423 (335%)
Cash: $1,057 (837% of Medicare)
Ins. Median: $423 (335% 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 335% of the Medicare baseline (a markup of 235%). 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 $66 - $1,057 52%
Keystone Hmo Proactive $66 52%
Ibc Commercial Hpn $68 54%
Medicaid / KanCare $75 - $1,057 59%
Health Partners $89 - $1,057 70%
Tricare $94 74%
Us Family Health Plan $94 74%
Medicare (plans) $95 - $97 75%
Philadelphia Va Medical Center $95 75%
Upmc $95 - $1,057 75%
Keystone Mercy Health Plan $96 - $1,057 76%
Ibc $97 77%
Cigna $98 - $256 78%
Geisinger Health Plan $98 - $301 78%
Humana $98 - $846 78%
Pa Health And Wellness $100 - $157 79%
Penn Life (Living Independently For Elders) $100 79%
Aetna $101 - $1,057 80%
UnitedHealthcare $101 - $1,057 80%
Clover Health Plan $103 82%
Keystone First $105 83%
Pa Medical Assistance $105 83%
Gateway Health Plan $118 93%
Elap $135 107%
Claims Watcher $152 - $171 120%
Oscar Health Plan $161 128%
Centivo $171 135%
Elap Services $177 140%
Horizon Nj Health $179 - $186 142%
Highmark $200 158%
Pgm - Regie De L'Assurance Maladie Quebec $243 192%
Penn Global Medicine $252 200%
Preferred Health Care Eliance $264 209%
Pgm - Kuwait Defense $370 - $476 293%
Devon $402 - $476 318%
Qualcare $402 318%
Coventry $423 - $539 335%
Pgm - Chop $423 335%
Wissahickon Hospice $423 335%
Healthamerica/Coventry $476 - $518 377%
Olympus $501 397%
First Health Global $528 418%
Urn-Cancer Resource Services $528 418%
Health Net $634 502%
Pgm - Royal Embassy Of Saudi Arabia $634 502%
Pgm - Embassy Of Qatar $687 544%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $687 544%
Pgm - Embassy Of The United Emirates/Ipc $740 586%
Devon Health Services Inc $846 670%
Health America/Ccn $846 670%
Intergroup $846 670%
Pgm - Kuwait Health Division $846 670%
Pgm - Kuwait Oil $846 670%
Preferred Care $846 670%
Commercial Other $1,057 837%
International Pfs $1,057 837%
Magellan $1,057 837%
Quest Behavioral Health $1,057 837%
United Behavioral Health $1,057 837%
Workers Compensation $1,057 837%

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