CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Porter Hospital Inc

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $123
Cash Discount Price: $421
vs. Medicare Baseline: 0.97x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Porter Hospital Inc is $123. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $421. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 0.97x the Medicare baseline. Located in 115 Porter Drive, Middlebury, VT.

Cash / Self-Pay

$421

Average discount available for prompt cash payment at this facility.

Insurance Median

$123

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: $421 (333%)

Insurance Median: $123 (97%)

Cash: $421 (333% of Medicare)

Ins. Median: $123 (97% 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
UnitedHealthcare	$24 - $645	19%
Mvp	$29 - $608	23%
Fidelis Care	$31 - $276	25%
Humana	$33	26%
Aetna	$34 - $306	27%
Capital District Physicians' Health Plan	$34 - $544	27%
Martins Point	$34 - $306	27%
Veterans Affairs Community Care Network	$34 - $123	27%
Veterans Choice	$34 - $306	27%
Blue Cross Blue Shield	$39 - $614	31%
Harvard Pilgrim	$40 - $522	32%
Coventry	$45 - $574	36%
Cigna	$51 - $593	40%
Wellpath	$104 - $359	82%
Medical Corporation	$180 - $619	143%
Multiplan	$180 - $619	143%

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 $421.
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 Porter Hospital Inc 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.