CMS Price Transparency Data

Diagnostic mammogram (both breasts)

Facility: Good Samaritan Hospital of Suffern

Billing Code: 77066 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 77066
  • Insurance Median: $458
  • Cash Discount Price: $915
  • vs. Medicare Baseline: 2.92x Medicare
The contracted insurance negotiated median rate for a Diagnostic mammogram (both breasts) at Good Samaritan Hospital of Suffern is $458. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $915. Compared to the federal Medicare reimbursement reference rate of $156.98, this hospital’s rate is 2.92x the Medicare baseline. Located in 255 Lafayette Avenue, Suffern, NY.
Cash / Self-Pay
$915

Average discount available for prompt cash payment at this facility.

Insurance Median
$458

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: $915 (583%)
Insurance Median: $458 (292%)
Cash: $915 (583% of Medicare)
Ins. Median: $458 (292% 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 292% of the Medicare baseline (a markup of 192%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

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
Blue Cross Blue Shield $93 - $366 59%
Self-Pay $102 65%
Medicare (plans) $132 - $141 84%
Hamaspik (McR) $132 84%
Mvp Gold (McR) $132 84%
Tricare $132 84%
Affinity By Molina McR $138 88%
Beacon Exchange $158 101%
Beacon Commercial $171 109%
Emblem $263 - $558 168%
Aetna $412 - $458 262%
Geisinger Health Commercial/Exchange $435 277%
Cigna $438 - $640 279%
Self-Pay - Cc 50% $458 292%
Cdphp $458 292%
Mvp Exchange $469 299%
Emblem Select Care (Exchange) $520 331%
Emblem Ghi/Hip PPO $612 390%
Magnacare Standard $640 408%
PHCS $686 437%
Multiplan $686 437%
Oxford Exchange $702 447%
Emblem Ghi/Hip Hmo/Epo/Pos $732 466%
Oxford Commercial $755 481%
First Health $778 496%
Mvp $785 - $925 500%
UnitedHealthcare $808 - $951 515%
Magnacare Preferred $824 525%
Mvp Hmo/Ppo $912 581%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 255 Lafayette Avenue, Suffern, NY 10901
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals