CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Primary Children's Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $326
  • Cash Discount Price: $345
  • vs. Medicare Baseline: 2.08x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Primary Children's Hospital is $326. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $345. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 2.08x the Medicare baseline. Located in 100 North Mario Capecchi Drive, Salt Lake City, UT.
Cash / Self-Pay
$345

Average discount available for prompt cash payment at this facility.

Insurance Median
$326

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: $345 (220%)
Insurance Median: $326 (208%)
Cash: $345 (220% of Medicare)
Ins. Median: $326 (208% 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 208% of the Medicare baseline (a markup of 108%). 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
American Health $46 - $262 29%
Health Plan Of Nevada $46 - $124 29%
Healthy U $46 - $149 29%
Molina $46 - $386 29%
Selecthealth $46 - $386 29%
Southwest Behavioral Health $46 - $105 29%
UnitedHealthcare $46 - $386 29%
Tricare $104 66%
Triwest $104 66%
Ut Cancer Control $150 96%
Donor Connect $165 - $183 105%
Aetna $326 - $391 208%
Awh Connected $326 - $391 208%
Byu Athletics $326 - $386 208%
Campbell Scientific $326 - $386 208%
Cigna $326 - $386 208%
Deseret Mutual $326 - $386 208%
Emi $326 - $386 208%
Emi Health $326 - $386 208%
First Choice $326 - $386 208%
First Choice Of The Midwest $326 - $386 208%
Franklin County $326 - $386 208%
Global Excel $326 - $386 208%
Health Utah $326 - $386 208%
Humana $326 - $386 208%
Hygeia Corporation $326 - $386 208%
Ifit $326 - $386 208%
Juniper Systems $326 - $386 208%
Lw Miller $326 - $386 208%
Managed Care Admin $326 - $386 208%
Medcare International $326 - $386 208%
Motivhealth $326 - $386 208%
Pehp $326 - $386 208%
Prodegi Corp Benefit $326 - $386 208%
Tanner Llc $326 - $386 208%
Uofu $326 - $386 208%
Utah Tech $326 - $386 208%
Wise Network $326 - $386 208%
First Health $331 - $391 211%
Blue Cross Blue Shield $336 - $395 214%
Springtide $336 - $395 214%
Utah Behavioral Health Network $372 237%
Altius Mhnet Behavioral Health $405 258%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 100 North Mario Capecchi Drive, Salt Lake City, UT 84113
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Childrens