# Dexa Bone Density: Cost, Coverage, and What to Expect

Source: https://ourhealthnetwork.com/procedure-costs/dexa-bone-density
Last reviewed: 2026-04-17
Data: CMS Hospital and Outpatient pricing, CPT/HCPCS code mapping

## Quick answer

Medicare pays about $22 for a DEXA bone density scan, but commercial insurance and cash-pay patients often see sticker prices of $125 to $300, with the biggest swing coming from whether the scan happens in a hospital or a freestanding imaging center.

## What it is

A DEXA scan (dual-energy X-ray absorptiometry) is a quick, low-radiation imaging test that measures how much calcium and other minerals are packed into your bones. The result is a T-score that tells your doctor whether your bones are normal, thinning (osteopenia), or weak enough to be called osteoporosis. It is the gold-standard test for diagnosing bone loss and predicting fracture risk.

The scan itself is painless. You lie on a padded table while a mechanical arm passes over your hip, lower spine, and sometimes your forearm. There is no IV, no contrast dye, and no sedation.

- **Scan time:** 10 to 20 minutes from check-in to walkout
- **Radiation dose:** roughly 1/10 of a standard chest X-ray, far less than a CT scan
- **Prep:** none beyond skipping calcium supplements for 24 hours and wearing metal-free clothing
- **Anesthesia:** none; you stay fully awake and clothed
- **Body parts scanned:** hip and lumbar spine are standard; forearm added if hip or spine can't be read
- **Results:** usually back to your doctor within 1 to 3 business days

Almost all DEXA scans billed to Medicare use a single code, CPT 77080, which covers a central DEXA of the hip, pelvis, and spine. Peripheral DEXA (wrist or heel) and quantitative CT are separate tests with different codes and are less common for routine screening. The rest of this guide focuses on the standard central DEXA since that is what most people searching "bone density scan cost" are actually getting.

## When it is done

DEXA is usually done to screen for osteoporosis before you break a bone, or to track bone density over time once you've been diagnosed. The U.S. Preventive Services Task Force recommends routine screening for women 65 and older, and for younger postmenopausal women with risk factors.

Your doctor may recommend this when:

1. You are a woman age 65 or older, or a postmenopausal woman under 65 with risk factors like low body weight, smoking, or family history of hip fracture
2. You are a man 70 or older, or a younger man with risk factors like long-term steroid use or low testosterone
3. You have broken a bone after a minor fall or low-impact injury (a "fragility fracture")
4. You take medications that weaken bones, such as chronic corticosteroids, certain cancer therapies, or long-term proton pump inhibitors
5. You have a medical condition linked to bone loss, such as rheumatoid arthritis, celiac disease, hyperparathyroidism, or early menopause
6. You are being monitored on osteoporosis treatment and your doctor wants to see whether the drug is working

There is no good non-imaging alternative for measuring actual bone density. Blood and urine tests can flag rapid bone turnover, but they cannot replace the DEXA number. If DEXA is unavailable, quantitative CT is a higher-radiation, higher-cost backup. For most people, DEXA is the only test that matters.

## What you pay

DEXA is one of the cheaper imaging tests in medicine, but what you actually pay still depends heavily on your insurance and where the scan is done. Medicare reimburses about $22 on average. Commercial insurers typically pay two to four times that, and hospital outpatient departments often bill $300 or more before any negotiated discount. The scan itself has two parts: the technical fee (the machine and the tech) and the professional fee (the radiologist reading the images). Some bills combine them, some split them.

**If you're on Medicare:**

- DEXA is covered under Part B and subject to the annual Part B deductible ($257 in 2025 figure) and 20% coinsurance
- Medicare covers one screening scan every 24 months for qualifying patients, and more often if medically needed (for example, tracking a known osteoporosis treatment)
- A Medigap supplement usually wipes out the 20% coinsurance, leaving you at or near $0 after the deductible is met
- If your Part B deductible is already paid for the year, your share on a $22 scan is only about $4

**If you have commercial insurance:**

- Under ACA preventive-care rules, a screening DEXA is often fully covered with no cost-sharing for women 65+ and younger women at elevated risk
- If it's coded as diagnostic (follow-up for known bone loss, not screening), expect to pay toward your deductible first, then coinsurance
- In-network hospital outpatient claims often show a billed charge of $250 to $500, with the plan paying $90 to $180 and the patient owing $30 to $100 depending on plan design
- A freestanding imaging center is almost always cheaper than a hospital-affiliated radiology department for the same scan

**If you're uninsured or paying cash:**

- Many freestanding imaging centers post cash-pay rates of $80 to $150 for a DEXA
- Hospitals will often negotiate down to a cash-pay rate, but you usually have to ask and request their financial assistance policy in writing
- Bundled screening packages at imaging chains sometimes include DEXA plus interpretation for a single transparent price
- Some state and nonprofit osteoporosis programs offer free or low-cost screening days, especially around World Osteoporosis Day in October

## Anatomy of the bill

A DEXA bill has fewer moving pieces than most imaging studies, but you can still get hit by split billing if the scan is done at a hospital.

- **Technical fee (facility/equipment):** This covers the DEXA machine, the technologist's time, and the room. Medicare pays about $9 in a facility setting and $30 in an office or freestanding setting, because office-based claims include the cost of owning the machine. A commercial hospital charge for this line can be $150 to $350.
- **Professional interpretation fee (radiologist):** A radiologist reads the images and writes the report. This is billed separately from the scan itself and typically runs $15 to $60 under commercial insurance. Medicare pays about $10 to $15 for the read.
- **Contrast material:** None. DEXA uses a very low dose of X-ray and does not require contrast dye.
- **Sedation:** None. You are awake and dressed for the entire scan.
- **Coverage coding (screening vs. diagnostic):** This is the hidden line that changes everything. A scan billed with a screening diagnosis code on most commercial plans costs you $0 under ACA preventive rules. The same exact scan billed as diagnostic (because you already have osteoporosis or fracture history) runs through your deductible. Always ask the ordering clinician how it will be coded.

Because there is no anesthesia, no pathology, and no implant, a DEXA bill almost never surprises you with a separate specialist invoice the way a surgery does. The biggest risk is the hospital facility fee, which can double the total cost for the same procedure versus an imaging center down the street.

## Cost by state

Medicare pay for DEXA varies more than you'd expect for a single, standardized scan. Vermont sits at the cheap end at about $11 per scan, while Maryland tops the list at just over $32, nearly triple. Other low-payment states include Maine ($11), West Virginia ($12), and Oklahoma ($12). On the higher end, Washington D.C. ($30), New Jersey ($28), and Arizona ($26) stand out.

California dominates in volume with more than 2 million services, followed by Florida (1.56M), New York (1.48M), and Arizona (1.14M). Those four states account for roughly a quarter of all DEXA scans billed to Medicare nationally, largely a function of older population density.

Why costs vary by state:

- **Medicare GPCI adjustments** change physician pay based on local practice costs (rent, wages, malpractice), which is why high-cost-of-living areas like Maryland and D.C. pay more per scan
- **Place-of-service mix** differs by state; states with more office-based imaging have higher average Medicare payments because office billing captures the equipment cost
- **Commercial contract rates** also swing by state based on hospital market concentration; states with fewer dominant health systems tend to negotiate lower commercial rates
- **State price-transparency laws** in places like California and New York make shopping easier, which can pull cash prices down over time

## Office vs facility

Where you get your DEXA scan matters more than anything else on this bill. Medicare data shows a near-even volume split, with 1.62 million scans in office or freestanding settings versus 1.16 million in hospital-based facilities. The payment difference is dramatic: about $30 in an office versus $9 in a facility setting for the professional/technical split. That is because office-based billing wraps the equipment cost into the claim, while hospital facility fees are billed separately and often run much higher on the commercial side.

For cash-pay and commercial patients, the real choice is hospital outpatient radiology versus a freestanding imaging center. The same scan can cost 2x to 4x more at a hospital-affiliated department.

When a hospital radiology department makes more sense:

- You have complex medical conditions and want your imaging under the same system as your specialist
- Your insurance plan only contracts with the hospital's radiology group
- You need the DEXA the same day as another hospital-based test or appointment

When a freestanding or office-based imaging center makes more sense:

- You are paying cash or have a high deductible and want the lowest sticker price
- You want faster scheduling and a shorter visit (often under 30 minutes door-to-door)
- You are on Medicare with a supplement and just want a clean, low-friction scan

## Who performs the procedure

Diagnostic radiologists read the overwhelming majority of DEXA scans. In the Medicare data, about 10,000 radiologists interpret DEXA images, handling roughly 82% of the reading volume. The person operating the machine itself is usually a registered radiologic technologist, not a physician.

Outside of radiology, endocrinologists and rheumatologists are the biggest specialist readers, because they manage the patients most likely to need repeat scans. Internal medicine and nurse practitioners account for a smaller share, mostly in primary-care-based bone health clinics.

What to look for when choosing a specialist or imaging center:

- **Accreditation:** Look for ACR (American College of Radiology) accreditation for DEXA, which means the machine is calibrated and the staff is trained
- **ISCD certification:** The International Society for Clinical Densitometry certifies both technologists (CBDT) and physicians (CCD); certified readers have better reproducibility
- **Same machine for follow-up:** Bone density comparisons are only reliable on the same DEXA machine, so if you're tracking treatment, return to the same center
- **Clear reporting:** A good DEXA report includes T-scores, Z-scores, and a FRAX 10-year fracture risk estimate, not just a pass/fail
- **Turnaround time:** Reports should reach your ordering physician within 3 business days

Specialties with fewer than 25 providers in the data (not shown here) are typically assistants or consulting readers, not the primary interpreter of a screening DEXA. Internal medicine and family practice clinicians usually order the scan but send the images to a radiologist to read.

## How to shop for the best price

DEXA is one of the few imaging tests where shopping actually pays off, because the scan is identical everywhere and the price swing is huge.

1. **Ask your doctor to code it as screening if you qualify.** Under ACA rules, most commercial plans cover preventive osteoporosis screening at $0 for eligible women. A "diagnostic" code can shift the same scan onto your deductible.
2. **Request a Good Faith Estimate.** Federal law (No Surprises Act, 2022) requires providers to give uninsured and self-pay patients a written cost estimate before scheduled services. Ask for it by name.
3. **Call at least two freestanding imaging centers for a cash-pay quote.** Include the CPT code (77080) so the quote is apples-to-apples. Note whether the price includes the radiologist's read.
4. **Compare to the hospital's chargemaster and negotiated rate.** Hospitals are required to post these online. The cash-pay rate is often 50% to 70% off the billed charge.
5. **Verify the radiologist is in-network.** If the imaging center is in-network but the reading radiologist is not, you can get a separate out-of-network bill for the interpretation.
6. **Ask about bundling.** Some centers offer a women's health bundle that includes DEXA plus mammogram or lab work at a single transparent price.
7. **Check nonprofit and community screening events.** Local health departments, osteoporosis foundations, and pharmacy chains occasionally run low-cost or free DEXA days, especially in October.

Red flags: a vague quote that doesn't separate the technical and professional fees, a hospital that won't confirm a cash-pay price without admission to billing, or an ordering physician who insists on a hospital-owned imaging department without a medical reason. For a $22 Medicare scan that can retail at $500, the difference between a good and bad shopping decision is real money.

## Surprise billing risks

DEXA is one of the lower-risk imaging tests for surprise billing, but it is not zero. The two places bills most commonly blow up for this scan are the split between the facility and the radiologist, and the screening-versus-diagnostic coding question.

Most common surprise-billing sources:

- **Out-of-network radiologist reading an in-network scan:** The imaging center is in-network, but the radiology group that reads the images contracts separately and may be out-of-network
- **Hospital facility fee on an outpatient scan:** A DEXA at a hospital-affiliated imaging department can generate a separate facility fee on top of the scan itself, doubling the bill compared to a freestanding center
- **Diagnostic coding on what you thought was a screening scan:** If you already have osteopenia, osteoporosis, or a prior fracture, the scan may be coded diagnostic and run through your deductible instead of being free under preventive rules
- **Follow-up scans inside the 24-month Medicare window:** Medicare covers one screening DEXA every 2 years; an earlier repeat needs a specific medical-necessity code or you will get denied

If you get a surprise bill:

- Do not pay until you have an itemized bill with CPT and diagnosis codes
- For commercial plans, the No Surprises Act protections may apply; request arbitration through cms.gov/nosurprises if you were billed out-of-network at an in-network facility
- Call your insurer and ask specifically whether the scan was processed as preventive or diagnostic, and request re-coding if you qualified for preventive coverage
- If the provider won't budge, file a complaint with your state insurance commissioner and request an internal appeal in writing

## Total recovery cost

DEXA has essentially no recovery. You walk in, lie on a table for 10 to 20 minutes, and walk out. Most people are back at work or running errands within the hour. There is no bruising, no soreness, no lifting restriction, and no follow-up imaging for the scan itself.

The real downstream costs come from what the scan finds, not the scan itself. If your T-score is normal, you are done until your next screening. If it shows osteopenia or osteoporosis, a chain of follow-up visits and prescriptions usually begins.

Add-on costs to budget for:

- **Follow-up visit with primary care or endocrinology:** $100 to $300 commercial, $20 to $40 Medicare copay
- **Lab work to rule out secondary causes:** vitamin D, calcium, thyroid, and sometimes parathyroid panels, typically $50 to $200 commercial
- **FRAX 10-year fracture risk calculation:** usually free, included in the DEXA report
- **Osteoporosis medication if prescribed:** generic alendronate can be $10 to $30 per month; branded injectables like denosumab or romosozumab can run $1,000+ per dose before insurance
- **Vitamin D and calcium supplements:** $10 to $30 per month
- **Repeat DEXA in 1 to 2 years:** same cost as the initial scan, often at the same center for comparability
- **Physical therapy or balance classes for fracture prevention:** $30 to $75 per session if prescribed

For a simple screening DEXA with a normal result, your realistic total cost is the scan plus maybe one short office visit. For a scan that reveals osteoporosis, the total first-year episode (scan, visits, labs, generic medication) can run several hundred dollars out-of-pocket on most commercial plans. On Medicare with a supplement, that total usually stays under $100. The DEXA sticker price is only the opening line on that bill.

## Variants of this procedure

- DEXA Scan (Hip, Spine, Pelvis)

## Frequently asked questions

### How much does a bone density scan cost with insurance?

With commercial insurance, your out-of-pocket for a DEXA is typically $0 to $75. If the scan is coded as preventive osteoporosis screening and you meet ACA eligibility criteria (most commonly women 65+), it's often fully covered with no cost-sharing. If it's coded as diagnostic, you pay toward your deductible and then coinsurance, with total billed charges usually $125 to $300.

### Does Medicare cover DEXA scans?

Yes. Medicare Part B covers DEXA bone density scans every 24 months for qualifying patients, and more often when medically necessary (for example, monitoring osteoporosis treatment). After the Part B deductible ($257 in 2025 figure), you pay 20% coinsurance, which on a $22 scan is only about $4. A Medigap plan usually covers the coinsurance entirely.

### How long does a bone density scan take?

The scan itself takes 10 to 20 minutes. You stay fully dressed, lie on a padded table, and a mechanical arm passes over your hip and lower spine. There's no IV, no contrast, and no recovery time. Most people are in and out of the imaging center in under an hour.

### Is a DEXA scan done in a hospital or outpatient?

Almost always outpatient. Medicare data shows roughly half of DEXA scans happen in hospital outpatient departments and half in freestanding imaging centers or physician offices. You do not need to stay overnight, and a hospital-based scan is usually more expensive than the same scan at a freestanding imaging center.

### How do I avoid a surprise bill on a DEXA?

Ask for a Good Faith Estimate before the scan, confirm that both the imaging center and the reading radiologist are in-network, and ask your ordering physician whether the scan will be coded as screening or diagnostic. The screening-versus-diagnostic code is the single biggest factor in whether you pay $0 or go through your deductible.

### What's the cheapest way to get a bone density scan?

Freestanding imaging centers almost always beat hospital-affiliated radiology departments on cash-pay price, with typical negotiated rates of $80 to $150. Call two or three centers with the CPT code (77080) for an apples-to-apples quote. Some pharmacy chains and community health events also run low-cost DEXA screening days, especially in October.

### How often should I get a DEXA scan?

Medicare covers a screening DEXA every 24 months. If you're on osteoporosis treatment or your doctor is tracking rapid bone loss, a repeat may be medically necessary sooner, typically at 1 to 2 year intervals. For patients with normal results and no risk factors, most guidelines suggest rescreening every 2 to 5 years.

### Where does this cost data come from?

The Medicare figures on this page come from the CMS Medicare Physician and Other Practitioners Public Use File, which reports the average allowed amount and charge for every HCPCS code billed to Medicare. Commercial and cash-pay figures are modeled as typical ranges derived from published hospital transparency data and common multiples of Medicare rates. Your actual bill will depend on your specific plan, your deductible status, and the provider's contracted rates.

## Related

- [All procedure cost concepts](https://ourhealthnetwork.com/procedure-costs)
- [Find specialists who perform this procedure](https://ourhealthnetwork.com/find-doctors)
- [Insurance plans that cover this procedure](https://ourhealthnetwork.com/tools/insurance-matcher)