CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Hospital Pavia Arecibo

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $28
Cash Discount Price: $200
vs. Medicare Baseline: 0.22x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Hospital Pavia Arecibo is $28. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $200. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.22x the Medicare baseline. Located in Carretera 129 Km.1 Avenida San Luis, Arecibo, PR.

Cash / Self-Pay

$200

Average discount available for prompt cash payment at this facility.

Insurance Median

$28

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: $200 (158%)

Insurance Median: $28 (22%)

Cash: $200 (158% of Medicare)

Ins. Median: $28 (22% 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
Cigna	$20	16%
Comerciales	$20	16%
Corecare	$20	16%
Mapfre	$20	16%
Mcs	$20 - $100	16%
Plan De Salud Menonita	$20 - $28	16%
Prossam	$20	16%
First Medical	$21 - $28	17%
Humana	$28 - $100	22%
Plan Auxilio Mutuo	$28	22%
Triple S	$28 - $100	22%
Bl	$34	27%
Privado	$34	27%
Mso	$59 - $60	47%
Ch	$100	79%
Tricare	$100	79%
Va	$100	79%

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 $200.
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 Hospital Pavia Arecibo 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.