CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: St Mary Medical Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $204
Cash Discount Price: $524
vs. Medicare Baseline: 1.62x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at St Mary Medical Center is $204. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $524. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.62x the Medicare baseline. Located in Langhorne-Newtown Rd, Langhorne, PA.

Cash / Self-Pay

$524

Average discount available for prompt cash payment at this facility.

Insurance Median

$204

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: $524 (415%)

Insurance Median: $204 (162%)

Cash: $524 (415% of Medicare)

Ins. Median: $204 (162% 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
Medicaid / KanCare	$76 - $288	60%
Pace-Trinity Health	$89	70%
Blue Cross Blue Shield	$95 - $247	75%
Cigna	$96 - $542	76%
Align Senior Care	$97	77%
Medicare (plans)	$97 - $171	77%
Aetna	$101 - $717	80%
Health America Advantra	$114	90%
UnitedHealthcare	$123 - $390	97%
Ambetter / Centene	$170	135%
Oscar	$171	135%
Prime Healthcare	$171	135%
Jefferson Health Plan Commercial	$173	137%
Homestead Health Plans Woods Center	$185	147%
Amerihealth	$204	162%
Blue Shield - Ca	$204	162%
Blue Shield - Id (Regence)	$204	162%
Blue Shield - Ny Highmark Western	$204	162%
Blue Shield - Wa (Regence)	$204	162%
Group Pension Administrators	$214	170%
Reedman Toll	$214	170%
Blue Shield - Pa (Highmark)	$257	204%
Keystone First	$288	228%
Keystone First Chip	$288	228%
Geha	$329	261%
Upmc Health Plan	$542	429%
Webtpa	$542	429%
Meritain	$717	568%
Multiplan	$725	574%
Prime Health Services	$725	574%
Galaxy Health Network	$766	607%
Three Rivers Provider Network	$766	607%

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 $524.
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 St Mary Medical Center 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.