How Much Does a Mammogram Cost?

Last Updated on April 18, 2024
Written by CPA Alec Pow | Content Reviewed by CFA Alexander Popinker

Mammography plays a crucial role in the early detection of breast cancer through detailed x-ray screening. But what are the true out-of-pocket costs for this potentially lifesaving exam?

How Much Does a Mammogram Cost Without Insurance?

A mammogram can cost from $0 up to more than $1,000. On average, you can expect to pay $100 to $200 or more for a standard screening mammogram without insurance. However, the Affordable Care Act requires insurers to cover mammograms fully starting at age 40. Diagnostic mammograms cost more.

Uninsured Mammogram Costs:

• Screening Mammogram:
  • Hospital – $250 to $500
  • Imaging Center – $125 to $250
• Diagnostic Mammogram:
  • Hospital – $350 to $600
  • Imaging Center – $200 to $400
• Radiologist Fee – $100 to $250

Insured Mammogram Costs:

• Screening Mammogram:
  • $0 copay with insurance (free with mandated ACA coverage)
• Diagnostic Mammogram:
  • 20% coinsurance for Medicare patients
  • Copays vary for private insurance, ~$50 to $150
• Radiologist Fee:
  • Covered fully by Medicare
  • Copay or coinsurance with private insurance

Additional potential costs:

• Facility Fees – $50 to $200
• Biopsy – $500 to $1,000
• Breast MRI – $1,000 to $5,000

Additional charges may apply for specialists, biopsies, ultrasounds, or MRIs for follow-up. Whenever covered, use insurance and seek financial assistance if needed.

Compare providers in your area to find affordable options like community clinics. Don’t avoid screening solely due to money concerns. Catching cancer early makes a tremendous difference.

According to GoodRx, the average cost of a digital screening mammogram in the US is between $144 and $227 without insurance.

The National Cancer Institute provides information on the cost of mammograms, including how to obtain free or low-cost screenings for uninsured or low-income women.

The Mayo Clinic provides information on the cost of screening mammograms, including a cost estimate of between $600 and $1,050 for the service.

Ganeshdiagnostic mentions that the cost of a mammogram without insurance can range from $150 to $4,500 in the US, depending on factors such as location, type of mammogram, and whether further imaging or diagnostic tests are required.

What is a Mammogram?

A mammogram is a specialized breast x-ray primarily used to detect early warning signs of cancerous tumors or lesions. There are two main mammogram types:

• Screening mammograms check for potential tumors in asymptomatic patients as a preventive screening measure. These are recommended as routine annual exams starting between ages 40-50 depending on personal risk factors.
• Diagnostic mammograms follow up on potential breast issues like a lump or abnormal screening results via more detailed and targeted breast imagery.

While involving very low radiation exposure, mammograms provide potentially lifesaving data by identifying cancers early when they are most treatable. Don’t avoid this essential screening.

What Influences Mammogram Costs?

Several variables affect the total cost of mammogram imaging services:

• 2D vs 3D Technology – 3D breast tomosynthesis exams cost more but deliver more accurate results by scanning through multiple imaging planes. Traditional 2D mammograms remain common despite limitations.
• Screening vs Diagnostic Purpose – Diagnostic mammograms warrant higher associated procedural fees and radiologist interpretation costs due to their more specialized nature.
• Location Type – Hospital pricing is generally higher across the board compared to private outpatient imaging centers.
• Geographic Region – Rates at both hospitals and clinics vary based on location, with major metropolitan areas costing much more than rural regions.
• Radiologist Fees – Specialist charges for analyzing results range from $80 to $200+ and may be billed separately from the procedure itself.

Understanding these cost drivers allows you to make informed decisions about where to undergo screening mammography based on your specific insurance policy provisions, risk factors, and household budget tradeoffs. Don’t simply default to the closest provider without comparing costs.

Insurance and Mammogram Costs

The Affordable Care Act mandates most health plans fully cover preventive screening mammograms without copays, deductibles or coinsurance fees starting at age 40, averaging once annually. Diagnostic mammograms may involve cost-sharing until you meet your deductible based on the specifics of your policy.

Here are the general screening mammogram provisions under common insurance programs:

• Medicare – Fully covers one preventive mammogram every 12 months at no out-of-pocket cost to patients age 40 and over. No Medicare Part B deductible is required. Diagnostic mammograms have 20% coinsurance cost-sharing.
• Medicaid – Varies by state but must fully cover mammograms as an essential preventive benefit typically starting at age 40 without copays or limitations following USPSTF guidelines. Subsequent diagnostics may involve copays.
• Private Insurance – Required to cover preventive mammograms without patient copays or deductibles annually or as recommended by physician starting at age 40. Diagnostic exams may incur cost-sharing until the policy deductible is satisfied.

You might also like our articles on the cost of a colonoscopy, biopsy, or chemotherapy.

Even with mandated insurance coverage, always verify your benefits. Seek financial assistance from organizations like Komen if needed to avoid delayed essential screening. Early detection saves lives.

Why are Regular Mammograms Important?

Despite some out-of-pocket costs even with insurance, maintaining regular mammography screenings as recommended provides tremendous long-term financial and health benefits:

• Finding cancer early through routine mammograms dramatically improves survival outcomes and reduces need for expensive mastectomies or chemotherapy which carry additional financial toxicity hardships.
• Early intervention at initial stages enables less invasive lumpectomy procedures and radiation versus full mastectomies and reconstructive surgery which increase treatment costs significantly.
• Catching cancer before it spreads avoids exponentially higher cumulative medical expenses over a lifetime associated with ongoing cancer drug therapies, hospitalizations, procedures, and end-of-life care costs.

Paying reasonable screening prices today to catch issues early prevents crushing expenses both medically and financially tomorrow. Don’t delay mammography – the dividends in health and avoided long-term costs outweigh concerns over modest copays.

Final Words

Mammograms serve an invaluable role detecting breast cancer early when it is most treatable. While screening involves some out-of-pocket expense even with required insurance coverage, maintaining regular checkups saves lives and significant costs over the long run.

Compare your options to find affordable providers. And seek financial assistance if needed – don’t let pricing deter these essential cancer detection scans. Being proactive is the wisest investment you can make in your health.

Frequently Asked Questions

Can you wear a bra during a mammogram?

It is recommended to avoid wearing underwire bras to mammogram appointments, as the metal in the wiring can appear on the images and potentially obscure breast tissue that needs clear visibility.

Instead, wear a comfortable wireless sports bra or soft bralette, or change into a gown/vest provided by the imaging facility. Be sure to notify the technician of any implants or surgery.

Are mammograms worth doing?

Yes, mammography remains among the most reliable and non-invasive methods for early breast cancer detection, recommended by major medical organizations for women starting between ages 40-50 based on individual risk profiles.

While false positives are possible, the overwhelming benefits of early diagnosis and improved survival rates makes maintaining regular age-appropriate mammogram screenings absolutely worthwhile for nearly all women. Don’t delay this potentially lifesaving preventive care.

How long can you go without a mammogram?

Most medical professional organizations advise women get annual mammogram screenings beginning at age 40 or 50 depending on individual risk factors. At a minimum, mammography at least every 1-2 years is highly recommended through age 55, after which screenings every 1-3 years is sufficient for the average risk woman.

Age 70+ can extend to every 2-4 years based on physician guidance. But don’t go over 2 years maximum without a mammogram when younger unless otherwise advised by your provider based on unique health status. Consistency saves lives through early cancer detection.