CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Brattleboro Memorial Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $121
Cash Discount Price: $385
vs. Medicare Baseline: 0.96x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Brattleboro Memorial Hospital is $121. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $385. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.96x the Medicare baseline. Located in 17 Belmont Ave, Brattleboro, VT.

Cash / Self-Pay

$385

Average discount available for prompt cash payment at this facility.

Insurance Median

$121

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: $385 (305%)

Insurance Median: $121 (96%)

Cash: $385 (305% of Medicare)

Ins. Median: $121 (96% 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
Amerihealth-Caritas	$30 - $110	24%
New Hampshire Healthy Families	$30 - $110	24%
Wellsense	$30 - $132	24%
Blue Cross Blue Shield	$34 - $868	27%
Cigna	$34 - $522	27%
Harvard Pilgrim Health Care	$34 - $478	27%
Martin'S Point	$34 - $123	27%
Mvp Healthcare	$34 - $495	27%
New Hampshire Healthy Families (Wellcare)	$36 - $129	29%
UnitedHealthcare	$62 - $522	49%
Tufts Health Plan	$88 - $503	70%
Humana	$89	70%
Multiplan	$98 - $534	78%
Vermont Health Plan	$121 - $492	96%
Aetna	$534	423%
Coventry	$534	423%
Health New England	$534	423%

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 $385.
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 Brattleboro Memorial Hospital 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.