CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Kenmore Mercy Hospital

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $152
  • Cash Discount Price: $204
  • vs. Medicare Baseline: 0.97x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Kenmore Mercy Hospital is $152. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $204. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 0.97x the Medicare baseline. Located in 2950 Elmwood Avenue, Kenmore, NY.
Cash / Self-Pay
$204

Average discount available for prompt cash payment at this facility.

Insurance Median
$152

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: $204 (130%)
Insurance Median: $152 (97%)
Cash: $204 (130% of Medicare)
Ins. Median: $152 (97% 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.

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
UnitedHealthcare $60 - $181 38%
Univera Healthcare Essential [100170] $71 - $131 45%
Medicaid / KanCare $86 - $152 55%
Independent Health Essential [100166] $86 - $148 55%
Blue Cross Blue Shield $105 - $220 67%
Catholic Health Life Pace [400005] $106 - $152 68%
VA Veterans Affairs [700001] $106 - $129 68%
Medicare (plans) $106 - $179 68%
Fallon Health [450115] $106 - $152 68%
Champ VA [700002] $106 - $152 68%
Seneca Nation [450119] $106 - $152 68%
Cigna $106 - $220 68%
Hospice [550001] $106 - $152 68%
Tricare $106 - $152 68%
Federal Workers Compensation [500100] $106 - $334 68%
Covid19 Hrsa [45013] $106 - $152 68%
Univera Healthcare [100169] $110 - $185 70%
Fidelis Dual Advantage [450120] $110 - $159 70%
Wellcare Fidelis Dual [450451] $110 - $159 70%
Aetna $111 - $159 71%
Wellcare [450129] $111 - $167 71%
Humana $111 - $159 71%
Vna Option Mltc [350110] $127 81%
Amerigroup [350102] $127 81%
Excellus Rochester McD [350117] $127 81%
Crime Victims [100176] $127 81%
Tuscarora Nation [550120] $127 81%
Fidelis Essential [100163] $132 - $220 84%
Molina Essential [100167] $132 - $286 84%
Beacon Essential [350122] $136 - $182 87%
Ghi [100153] $144 92%
Independent Health [100165] $154 - $296 98%
Fidelis Exchange [100164] $159 - $182 101%
Beacon Health Options [100023] $182 116%
Iha First Choice [800001] $197 - $303 125%
Mvp Healthcare [100168] $205 131%
No Fault [114001] $234 - $334 149%
UPMC Health Plan [100181] $273 174%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 2950 Elmwood Avenue, Kenmore, NY 14217
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals