Diagnostic mammogram of one breast at Samaritan Hospital

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

PR Mammography Diagnostic Unilat Including Cad|PROFESSIONAL COMPONENT

Troy, NY

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How this price compares nationally

Samaritan Hospital’s median price of $319 is 93% above the median hospital's median price ($165), higher than 83% of the 2,433 hospitals reporting CPT 77065. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting CPT 77065 at Samaritan Hospital

Negotiated rates from the hospital’s own file: 34 payers, 108 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Humana tricare professional · fee schedule · inpatient	$73	$73	$39	53%	—	$35 – $112
2	Humana tricare professional · fee schedule · outpatient	$73	$73	$39	53%	—	$35 – $112
3	Tricare tricare professional · fee schedule · inpatient	$73	$73	$39	53%	—	$35 – $112
4	Tricare tricare professional · fee schedule · outpatient	$73	$73	$39	53%	—	$35 – $112
5	Anthem empire bcbs medicare advantage facility · fee schedule · both	$80	$80	—	—	—	$80 – $80
6	UnitedHealthcare united healthcare medicaid harp chip facility · fee schedule · both	$81	$81	—	—	—	$81 – $81
7	Excellus blue shield of ne new york medicare adv facility · fee schedule · both	$82	$82	—	—	—	$82 – $82
8	Highmark blue shield of ne new york medicare adv facility · fee schedule · both	$82	$82	—	—	—	$82 – $82
9	UnitedHealthcare united healthcare medicare advantage facility · fee schedule · both	$83	$83	—	—	—	$83 – $83
10	Aetna aetna medicare advantage facility · fee schedule · both	$87	$87	—	—	—	$87 – $87
11	WellCare wellcare medicare advantage facility · fee schedule · both	$89	$89	—	—	—	$89 – $89
12	Anthem empire medicaid facility · fee schedule · both	$104	$104	—	—	—	$104 – $104
13	Excellus empire medicaid facility · fee schedule · both	$104	$104	—	—	—	$104 – $104
14	WellCare wellcare ep 1&2 medicaid facility · fee schedule · both	$131	$131	—	—	—	$131 – $131
15	Aetna pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$210	$210	$127	60%	—	$83 – $336
16	Ambetter pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$210	$210	$127	60%	—	$83 – $336
17	Amerihealth Caritas pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$210	$210	$127	60%	—	$83 – $336
18	Anthem pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$210	$210	$127	60%	110–173	$83 – $336
19	Blue Cross Blue Shield pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$210	$210	$127	60%	89–224	$83 – $336
20	Carefirst pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$210	$210	$127	60%	1–10	$83 – $336
21	Caresource pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$210	$210	$127	60%	—	$83 – $336
22	Cigna pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$210	$210	$127	60%	1–10	$83 – $336
23	Clover pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$210	$210	$127	60%	—	$83 – $336
24	Devoted pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$210	$210	$127	60%	—	$83 – $336
25	Excellus pb xr 100% default professional · percent of total billed charges · outpatientfrom % of charges	$210	$210	$127	60%	1–10	$83 – $336

Page 1 of 5 · 108 rates

Last updated: Mar 31, 2026

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