CMS Price Transparency Data

Screening mammogram (both breasts)

Facility: Sisters of Charity Hospital

Billing Code: 77067 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77067
  • Insurance Median: $127
  • Cash Discount Price: $265
  • vs. Medicare Baseline: 1.01x Medicare
The contracted insurance negotiated median rate for a Screening mammogram (both breasts) at Sisters of Charity Hospital is $127. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $265. Compared to the federal Medicare reimbursement reference rate of $126.25, this hospital’s rate is 1.01x the Medicare baseline. Located in 2157 Main Street, Buffalo, NY.
Cash / Self-Pay
$265

Average discount available for prompt cash payment at this facility.

Insurance Median
$127

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: $265 (210%)
Insurance Median: $127 (101%)
Cash: $265 (210% of Medicare)
Ins. Median: $127 (101% 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.

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
Univera Healthcare Essential [100170] $29 - $118 23%
Medicaid / KanCare $36 - $122 29%
Independent Health Essential [100166] $36 - $120 29%
Medicare (plans) $52 - $145 41%
UnitedHealthcare $60 - $147 48%
Independent Health [100165] $64 - $240 51%
Blue Cross Blue Shield $86 - $220 68%
Hospice [550001] $87 - $122 69%
Cigna $87 - $177 69%
Seneca Nation [450119] $87 - $122 69%
Tricare $87 - $122 69%
Covid19 Hrsa [45013] $87 - $122 69%
Fallon Health [450115] $87 - $122 69%
Catholic Health Life Pace [400005] $87 - $122 69%
Champ VA [700002] $87 - $122 69%
Federal Workers Compensation [500100] $87 - $269 69%
VA Veterans Affairs [700001] $87 - $104 69%
Wellcare Fidelis Dual [450451] $90 - $128 71%
Fidelis Dual Advantage [450120] $90 - $128 71%
Univera Healthcare [100169] $91 - $150 72%
Humana $92 - $128 73%
Wellcare [450129] $92 - $134 73%
Aetna $92 - $128 73%
Amerigroup [350102] $104 82%
Excellus Rochester McD [350117] $104 82%
Tuscarora Nation [550120] $104 82%
Crime Victims [100176] $104 82%
Vna Option Mltc [350110] $104 82%
Iha First Choice [800001] $107 - $303 85%
Beacon Essential [350122] $110 - $147 87%
Ghi [100153] $116 92%
Fidelis Exchange [100164] $131 - $147 104%
Fidelis Essential [100163] $132 - $220 105%
Molina Essential [100167] $132 - $235 105%
Beacon Health Options [100023] $147 116%
Mvp Healthcare [100168] $166 131%
No Fault [114001] $194 - $269 154%
Workers Compensation [500101] $194 - $269 154%
UPMC Health Plan [100181] $220 174%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2157 Main Street, Buffalo, NY 14214
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals