Mammography of both breasts
| DETAIL FOR SERVICES: | Study | Radiologist reading (interpretation) |
| 2020 CPT/HCPCS Primary Code | 77066 | Not provided by Hospital (may be billed separately) |
| Negotiated Private Fee | $170.00 | Not provided by Hospital (may be billed separately) |
| Prossam | $42.50 | Not provided by Hospital (may be billed separately) |
| Champva | $165.37 | Not provided by Hospital (may be billed separately) |
| First Medical | $40.00 | Not provided by Hospital (may be billed separately) |
| First Medical Vital | $85.05 | Not provided by Hospital (may be billed separately) |
| Plan de Salud Menonita | $42.50 | Not provided by Hospital (may be billed separately) |
| Menonita Vital | $78.82 | Not provided by Hospital (may be billed separately) |
| Humana Gold Plus / Gold Choice | $121.21 | Not provided by Hospital (may be billed separately) |
| Humana | $52.50 | Not provided by Hospital (may be billed separately) |
| Mapfre | $54.00 | Not provided by Hospital (may be billed separately) |
| Mcsclassicare | $52.50 | Not provided by Hospital (may be billed separately) |
| MCS Life | $70.00 | Not provided by Hospital (may be billed separately) |
| Medicare | $165.37 | Not provided by Hospital (may be billed separately) |
| MMM | $109.35 | Not provided by Hospital (may be billed separately) |
| MMM Vital | $86.53 | Not provided by Hospital (may be billed separately) |
| Panamerican Life | $35.00 | Not provided by Hospital (may be billed separately) |
| PMC | $109.35 | Not provided by Hospital (may be billed separately) |
| Tricare | $165.37 | Not provided by Hospital (may be billed separately) |
| Triple S Salud | $41.00 | Not provided by Hospital (may be billed separately) |
| Triple S Vital | $28.77 | Not provided by Hospital (may be billed separately) |
| Triple S Advantage | $121.21 | Not provided by Hospital (may be billed separately) |
| Negotiated Minimum Charge | $28.77 | Not provided by Hospital (may be billed separately) |
| Negotiated Maximum Charge | $165.37 | Not provided by Hospital (may be billed separately) |
| Discounted Cash Price | $136.00 | Not provided by Hospital (may be billed separately) |
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