Mammography, screening, bilateral
| DETAIL FOR SERVICES: | Study | Radiologist reading (interpretation) |
| 2020 CPT/HCPCS Primary Code | 77067 | Not provided by Hospital (may be billed separately) |
| Negotiated Private Fee | $140.00 | Not provided by Hospital (may be billed separately) |
| Prossam | $37.50 | Not provided by Hospital (may be billed separately) |
| Champva | $133.35 | Not provided by Hospital (may be billed separately) |
| First Medical | $35.00 | Not provided by Hospital (may be billed separately) |
| First Medical Vital | $70.53 | Not provided by Hospital (may be billed separately) |
| Plan de Salud Menonita | $37.50 | Not provided by Hospital (may be billed separately) |
| Menonita Vital | $63.52 | Not provided by Hospital (may be billed separately) |
| Humana Gold Plus / Gold Choice | $100.16 | Not provided by Hospital (may be billed separately) |
| Humana | $47.50 | Not provided by Hospital (may be billed separately) |
| Mapfre | $50.50 | Not provided by Hospital (may be billed separately) |
| Mcsclassicare | $44.00 | Not provided by Hospital (may be billed separately) |
| MCS Life | $59.00 | Not provided by Hospital (may be billed separately) |
| Medicare | $133.35 | Not provided by Hospital (may be billed separately) |
| MMM | $92.00 | Not provided by Hospital (may be billed separately) |
| MMM Vital | $71.55 | Not provided by Hospital (may be billed separately) |
| Panamerican Life | $40.00 | Not provided by Hospital (may be billed separately) |
| PMC | $92.00 | Not provided by Hospital (may be billed separately) |
| Tricare | $97.42 | Not provided by Hospital (may be billed separately) |
| Triple S Salud | $32.50 | Not provided by Hospital (may be billed separately) |
| Triple S Vital | $19.50 | Not provided by Hospital (may be billed separately) |
| Triple S Advantage | $100.16 | Not provided by Hospital (may be billed separately) |
| Negotiated Minimum Charge | $19.50 | Not provided by Hospital (may be billed separately) |
| Negotiated Maximum Charge | $133.35 | Not provided by Hospital (may be billed separately) |
| Discounted Cash Price | $112.00 | Not provided by Hospital (may be billed separately) |
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