CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Astria Toppenish Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77066
Insurance Median: $434
Cash Discount Price: $674
vs. Medicare Baseline: 2.76x Medicare

The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Astria Toppenish Hospital is $434. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $674. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 2.76x the Medicare baseline. Located in 502 W Fourth Ave, Toppenish, WA.

Cash / Self-Pay

$674

Average discount available for prompt cash payment at this facility.

Insurance Median

$434

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: $674 (429%)

Insurance Median: $434 (276%)

Cash: $674 (429% of Medicare)

Ins. Median: $434 (276% 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 276% of the Medicare baseline (a markup of 176%). 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
Medicaid / KanCare	$34 - $221	22%
Ambetter / Centene	$46	29%
UnitedHealthcare	$46 - $1,194	29%
Va	$46	29%
Medicare (plans)	$47 - $1,194	30%
Molina	$47	30%
Molina_Exchange	$59	38%
Li	$113	72%
Aetna	$116 - $1,272	74%
Cigna	$116	74%
Humana	$116 - $1,446	74%
Tricare	$116	74%
Zenith	$117	75%
Regence	$213 - $490	136%
Premera	$237 - $545	151%
Premera_Affordable_Care	$237 - $545	151%
Chpw_Cascade_Care	$396 - $911	252%
First_Choice	$434 - $998	276%
Kaiser	$453	289%
Tpsc	$491 - $1,128	313%
Bcchp	$629 - $1,446	401%
Great_Rivers	$629 - $1,446	401%
Healthcomp	$629 - $1,446	401%
Washington_State_Hca	$629 - $1,446	401%

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 $674.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 77066.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Astria Toppenish Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 77066.
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.