CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Pennsylvania Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $543
  • Cash Discount Price: $1,400
  • vs. Medicare Baseline: 3.46x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Pennsylvania Hospital is $543. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,400. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 3.46x the Medicare baseline. Located in 800 Spruce Street, Philadelphia, PA.
Cash / Self-Pay
$1,400

Average discount available for prompt cash payment at this facility.

Insurance Median
$543

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: $1,400 (892%)
Insurance Median: $543 (346%)
Cash: $1,400 (892% of Medicare)
Ins. Median: $543 (346% 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 346% of the Medicare baseline (a markup of 246%). 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 - $1,400 55%
Keystone Hmo Proactive $87 55%
Ibc Commercial Hpn $90 57%
Gateway Health Plan $91 - $143 58%
Medicaid / KanCare $91 - $1,400 58%
Health Partners $111 - $1,400 71%
Tricare $114 73%
Us Family Health Plan $114 73%
Medicare (plans) $115 - $117 73%
Philadelphia Va Medical Center $115 73%
Upmc $115 - $1,400 73%
Keystone Mercy Health Plan $116 74%
Ibc $117 75%
Cigna $119 - $310 76%
Geisinger Health Plan $119 - $365 76%
Humana $119 - $1,120 76%
Pa Health And Wellness $121 - $190 77%
Penn Life (Living Independently For Elders) $121 77%
Aetna $122 - $1,400 78%
UnitedHealthcare $122 - $1,400 78%
Clover Health Plan $124 79%
Keystone First $128 82%
Pa Medical Assistance $130 83%
Elap $164 104%
Claims Watcher $184 - $207 117%
Oscar Health Plan $196 125%
Centivo $207 132%
Elap Services $214 136%
Horizon Nj Health $237 - $246 151%
Highmark $242 154%
Penn Global Medicine $305 194%
Pgm - Regie De L'Assurance Maladie Quebec $322 205%
Preferred Health Care Eliance $364 232%
Pgm - Kuwait Defense $490 - $630 312%
Devon $532 - $630 339%
Qualcare $532 339%
Coventry $560 - $714 357%
Pgm - Chop $560 357%
Wissahickon Hospice $560 357%
Healthamerica/Coventry $630 - $686 401%
Olympus $680 433%
First Health Global $700 446%
Urn-Cancer Resource Services $700 446%
Health Net $840 535%
Pgm - Royal Embassy Of Saudi Arabia $840 535%
Pgm - Embassy Of Qatar $910 580%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $910 580%
Pgm - Embassy Of The United Emirates/Ipc $980 624%
Devon Health Services Inc $1,120 713%
Health America/Ccn $1,120 713%
Intergroup $1,120 713%
Pgm - Kuwait Health Division $1,120 713%
Pgm - Kuwait Oil $1,120 713%
Preferred Care $1,120 713%
Commercial Other $1,400 892%
Community Behavioral Health $1,400 892%
International Pfs $1,400 892%
Quest Behavioral Health $1,400 892%
United Behavioral Health $1,400 892%
Workers Compensation $1,400 892%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 800 Spruce Street, Philadelphia, PA 19107
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals