CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Reston Hospital Center

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $362
Cash Discount Price: $1,064
vs. Medicare Baseline: 2.87x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Reston Hospital Center is $362. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $1,064. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.87x the Medicare baseline. Located in 1850 Town Center Parkway, Reston, VA.

Cash / Self-Pay

$1,064

Average discount available for prompt cash payment at this facility.

Insurance Median

$362

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: $1,064 (843%)

Insurance Median: $362 (287%)

Cash: $1,064 (843% of Medicare)

Ins. Median: $362 (287% 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 287% of the Medicare baseline (a markup of 187%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Consult Patient Advocate

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
Humana	$104 - $107	82%
Devoted	$107	85%
Johns Hopkins	$107	85%
Sentara Health	$107	85%
United	$107 - $492	85%
Aetna	$109	86%
Virginia Premier Health	$110	87%
Blue Cross Blue Shield	$111 - $538	88%
Cigna	$112 - $557	89%
Davita Village Health	$112	89%
Clear Spring Health Plan	$113	90%
Align Senior Care	$115	91%
Pyramid Life	$115	91%
Lifeworks	$196 - $208	155%
Universal Healthcare Group	$227 - $241	180%
Carefirst	$362	287%
Greenvbrier Sporting Club	$620 - $657	491%
Virginia Health Network	$734 - $777	581%
Corvel	$744 - $788	589%
Occunet Workers Comp	$827 - $876	655%
4Most Health Network	$931 - $985	737%

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 $1,064.
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 Reston Hospital 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.