Grace Surgical Hospital — Mammogram prices
← Hospital overviewVerified from Grace Surgical Hospital’s published price file
Includes cash prices, list prices. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
4 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| HC MAMMO DIAG BIL W CAD Inpatient & outpatient | 77066 HCPCS | $1,279 | $537 | — | — | |
| HC MAMMO DIAG UNI W CAD Inpatient & outpatient | 77065 HCPCS | $1,002 | $421 | — | — | |
| HC MAMMO SCREEN BIL W CAD Inpatient & outpatient | 77067 HCPCS | $759 | $200 | — | — | |
| HC MAMMO SCREEN UNIL/BIL W CAD Inpatient & outpatient | 77067 HCPCS | $469 | $125 | — | — |