CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Astria Sunnyside Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 77067
Insurance Median: $311
Cash Discount Price: $639
vs. Medicare Baseline: 2.46x Medicare

The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Astria Sunnyside Hospital is $311. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $639. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 2.46x the Medicare baseline. Located in 1016 Tacoma Avenue, Sunnyside, WA.

Cash / Self-Pay

$639

Average discount available for prompt cash payment at this facility.

Insurance Median

$311

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: $639 (506%)

Insurance Median: $311 (246%)

Cash: $639 (506% of Medicare)

Ins. Median: $311 (246% 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 246% of the Medicare baseline (a markup of 146%). 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	$97 - $379	77%
Medicare (plans)	$112 - $312	89%
Bcchp	$114	90%
Aetna	$124 - $1,087	98%
Healthcomp_Ihs	$124 - $303	98%
Humana	$124 - $1,112	98%
Molina	$124 - $303	98%
Va	$124 - $303	98%
Tricare	$125 - $306	99%
Regence	$260 - $635	206%
Cigna	$304 - $741	241%
Li	$311 - $758	246%
First_Choice	$380 - $926	301%
Tpsc	$395 - $963	313%
Kaiser	$397 - $970	314%
Premera	$412 - $1,005	326%
UnitedHealthcare	$430 - $1,050	341%
Fhpw	$445 - $1,087	352%
Healthcomp	$455 - $1,112	360%
Great_Rivers	$506 - $1,235	401%
Zenith	$506 - $1,235	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 $639.
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 Astria Sunnyside 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.