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All procedures › Mammogram (one breast)

Summit Pacific Medical Center

ElmaGrays Harbor CountyCritical Access Hospitals

Mammogram (one breast)

Quality: 2 of 5 (CMS overall rating)Earliest available date: call (360) 346-2222

What you may pay

With insurance from an employer or private plan
$308 to $396Depends on your plan. Each plan’s price at this hospital:
  • CHPW PEBB - ALL OTHER PLANS $308 Higher than typical
  • FIRST CHOICE - ALL PLANS $352 Higher than typical
  • AETNA COMM - ALL PLANS $396 Higher than typical
Typical at 31 hospitals we cover: $159 to $257 (each hospital’s middle plan price, hospital’s fee). Don’t see your plan? Ask your insurer for its rate here.
Paying yourself (cash price)
$238 Lower than typicalTypical hospital’s fee at 35 hospitals we cover: $240 to $450.

These are prices the hospital published, not a quote. With insurance you usually pay part of the rate (your deductible and coinsurance); the estimator on the procedure page works it out. A higher price does not mean better care.

Doctors usually bill separately. At most hospitals these are the hospital’s own charges. The surgeon, radiologist, anesthesiologist or pathologist usually sends a separate bill: ask each of them for an estimate too.

Source: Summit Pacific Medical Center’s own price file, dated 2026-08-31. CareNavIQ last refreshed prices on 2026-11-09.

Next step: ask the hospital for a Good Faith Estimate for this procedure (phone number above).

15 published prices, grouped by who each price applies to.

Cash price 1 price

The hospital's discounted price for patients paying without insurance.

PricePart of the billHospital’s descriptionHow it’s setSettingSource date
$238Hospital’s feeDiagnostic mammography of 1 breast—Outpatient2026-08-31

List price (before discounts) 1 price

The hospital's full chargemaster price. Few patients pay this amount.

PricePart of the billHospital’s descriptionHow it’s setSettingSource date
$440Hospital’s feeDiagnostic mammography of 1 breast—Outpatient2026-08-31

Commercial insurance 3 prices

Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.

PayerPlanPricePart of the billHospital’s descriptionHow it’s setSettingSource date
AETNA COMM - ALL PLANSAETNA COMM - ALL PLANS$396Hospital’s feeDiagnostic mammography of 1 breastpercent of total billed chargesOutpatient2026-08-31
CHPW PEBB - ALL OTHER PLANSCHPW PEBB - ALL OTHER PLANS$308Hospital’s feeDiagnostic mammography of 1 breastpercent of total billed chargesOutpatient2026-08-31
FIRST CHOICE - ALL PLANSFIRST CHOICE - ALL PLANS$352Hospital’s feeDiagnostic mammography of 1 breastpercent of total billed chargesOutpatient2026-08-31

Medicare Advantage 3 prices

Rate for a private Medicare Advantage plan. Applies only to members of that plan.

PayerPlanPricePart of the billHospital’s descriptionHow it’s setSettingSource date
CHPW MCR ADVCHPW MCR ADV$113Hospital’s feeDiagnostic mammography of 1 breastpercent of total billed chargesOutpatient2026-08-31
REGENCE BS MCR ADV - ALL PLANSREGENCE BS MCR ADV - ALL PLANS$110Hospital’s feeDiagnostic mammography of 1 breastpercent of total billed chargesOutpatient2026-08-31
WELLCARE MCR ADV - ALL PLANSWELLCARE MCR ADV - ALL PLANS$117Hospital’s feeDiagnostic mammography of 1 breastpercent of total billed chargesOutpatient2026-08-31

Medicaid managed care 3 prices

Rate for an Apple Health managed-care plan. Applies only to members of that plan.

PayerPlanPricePart of the billHospital’s descriptionHow it’s setSettingSource date
AMERIGROUP MCAID - ALL PLANSAMERIGROUP MCAID - ALL PLANS$112Hospital’s feeDiagnostic mammography of 1 breastpercent of total billed chargesOutpatient2026-08-31
CHPW CHIPCHPW CHIP$102Hospital’s feeDiagnostic mammography of 1 breastpercent of total billed chargesOutpatient2026-08-31
CHPW HEALTHY OPTIONSCHPW HEALTHY OPTIONS$102Hospital’s feeDiagnostic mammography of 1 breastpercent of total billed chargesOutpatient2026-08-31

Other government program 1 price

TRICARE, VA, Indian Health Service, workers' compensation, or another public program.

PayerPlanPricePart of the billHospital’s descriptionHow it’s setSettingSource date
TRIWEST - ALL PLANSTRIWEST - ALL PLANS$110Hospital’s feeDiagnostic mammography of 1 breastpercent of total billed chargesOutpatient2026-08-31

Unknown 3 prices

The source file doesn't say which population this rate applies to.

PayerPlanPricePart of the billHospital’s descriptionHow it’s setSettingSource date
CHPW BASIC HPCHPW BASIC HP$102Hospital’s feeDiagnostic mammography of 1 breastpercent of total billed chargesOutpatient2026-08-31
CIGNA - ALL PLANSCIGNA - ALL PLANS$352Hospital’s feeDiagnostic mammography of 1 breastpercent of total billed chargesOutpatient2026-08-31
UHC ALL PAYER - ALL PLANSUHC ALL PAYER - ALL PLANS$374Hospital’s feeDiagnostic mammography of 1 breastpercent of total billed chargesOutpatient2026-08-31

Doctors here who do this procedure

8 doctors affiliated with Summit Pacific Medical Center billed Traditional Medicare for Mammogram (one breast) in 2024, most Medicare services first. See all doctors and practices, including those with no hospital affiliation.

Doctor or practicePracticeMedicare quality scoreTimes billed to Traditional Medicare (2024)Traditional Medicare amount for their own service (2024)
Sean Koskinen, MDDiagnostic Radiology · RichlandOregon Healthcare Resources LLCGroup of 159 cliniciansNot rated158$37.27 at a hospital or surgery center
Gregory Balmforth, MDDiagnostic Radiology · SpokaneThe Polyclinic PLLCGroup of 365 cliniciansNot rated96$37.65 at a hospital or surgery center
Joseph Stengel, DODiagnostic Radiology · AberdeenGrays Harbor Community HospitalGroup of 88 clinicians85 of 100CMS MIPS 202460$37.60 at a hospital or surgery center
Scott Zelasko, MDDiagnostic Radiology · SpokaneThe Polyclinic PLLCGroup of 365 cliniciansNot rated54$145 in the office (no hospital amount)
Mariam Shehata, MDDiagnostic Radiology · SeattleThe Polyclinic PLLCGroup of 365 cliniciansNot rated49$139 in the office (no hospital amount)
Oksana Prychyna, MDDiagnostic Radiology · SpokaneVirginia Mason Medical CenterGroup of 867 cliniciansNot rated41$119 in the office (no hospital amount)
Jennifer Xiao, MDDiagnostic Radiology · SpokaneKaiser Foundation Health Plan Of WashingtonGroup of 1,526 cliniciansNot rated21$135 in the office (no hospital amount)
Gurpreet Dhillon, MDDiagnostic Radiology · SpokaneThe Polyclinic PLLCGroup of 365 cliniciansNot rated16$125 in the office (no hospital amount)

Reading the doctor list

  • A higher price doesn’t mean better care. The quality score and the price come from different CMS files and are shown separately on purpose.
  • The amount is what Traditional Medicare (original Medicare) approved for the doctor’s or lab’s own service: Medicare’s payment plus the patient’s share. It is not what commercial insurance or Medicare Advantage pays, and the hospital or surgery center bills separately (surgery centers aren’t in this list).
  • The Medicare quality score is CMS’s MIPS final score (0 to 100), based mostly on the doctor’s Medicare patients. About half of doctors aren’t scored, so Not rated says nothing bad about a doctor. A group’s score covers everyone in the group.
  • CMS doesn’t publish counts under 11 patients, so doctors who rarely bill Medicare for this aren’t listed, and No price published means CMS has no amount for that setting.
  • Medicare’s file doesn’t say where a doctor did the procedure, only that they billed it in Washington. Affiliations are the hospitals each doctor lists with Medicare.

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