Heads up: Screening mammograms (77067) are $0 covered under ACA for most insurers. If you're called back for a diagnostic mammogram (77066), cost-sharing may apply.
Mammograms screen for breast cancer or evaluate a specific concern (diagnostic). Annual screening mammograms are covered at $0 by most insurers under the ACA — confirmed by the data below. Diagnostic mammograms ordered because of a specific symptom or abnormality are billed differently and may have cost-sharing.
Tip: Annual screening mammograms (77067) are fully covered under the ACA with no cost-sharing at in-network facilities. Check the rates below — most insurers show $0.
| Code | Variant | When it applies | |
|---|---|---|---|
| CPT 77067 | Screening (both breasts) | Annual cancer screening — typically $0 covered | See exact rates → |
| CPT 77066 | Diagnostic (both breasts) | Ordered for a specific concern or symptom | See exact rates → |
| CPT 77065 | Diagnostic (one breast) | One-sided concern or follow-up | See exact rates → |
Ranges span all billing codes for this procedure. Actual rate depends on which variant is performed.
| Insurance | AdventHealth Tampa | AdventHealth Wesley Chapel | AdventHealth Zephyrhills | HCA Florida Brandon Hospital | HCA Florida Largo Hospital | HCA Florida South Tampa Hospital | HCA Florida Trinity Hospital | HCA Florida West Tampa Hospital |
|---|---|---|---|---|---|---|---|---|
| Molina | $33Best | $33Best | $33Best | $0 covered | $0 covered | $0 covered | $0 covered | — |
| Oscar Health | $63–$511Best | $66–$530 | $72–$581 | — | — | — | — | — |
| VA / Champva | — | — | — | $80–$102Best | $80–$102Best | $80–$102Best | $80–$102Best | $80–$102Best |
| Blue Cross Blue Shield | — | — | — | $82–$104Best | $82–$104Best | $82–$104Best | $82–$104Best | $82–$104Best |
| Humana | $69–$262Best | $159–$276 | $107–$276 | $84–$107 | $84–$107 | $84–$107 | $84–$107 | $84–$107 |
| Cigna | $128–$269 | $109–$247 | $111–$249 | $86–$109Best | $86–$109Best | $86–$109Best | $86–$109Best | $86–$109Best |
| Aetna | $140–$239 | $175–$264 | $178–$267 | $80–$102Best | $0 covered | $80–$102Best | $80–$102Best | $0 covered |
| Multiplan | $386–$452Best | $448–$525 | $448–$525 | $0 covered | $0 covered | $0 covered | $0 covered | — |
Source: Hospital price transparency files (federally required). Facility fees only.
Each hospital negotiates separate contracts with every insurer. For the same procedure, the rate can differ by 3–5x between hospital systems — larger systems have more leverage and command higher rates.
Facility fee only. The physician performing this procedure bills separately. Your out-of-pocket depends on your deductible and coinsurance. Federal law requires hospitals to provide a Good Faith Estimate before any non-emergency procedure.