# Mammography: Cost, Coverage, and What to Expect

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

## Quick answer

Medicare pays about $52 on average for mammography across screening and diagnostic types. Commercial insurance and cash prices run $150 to $500 or more; imaging setting and screening-versus-diagnostic status drive most of the cost difference.

## What it is

A mammogram is a low-dose X-ray of breast tissue used to find cancer early, often before you or a doctor can feel anything. The machine compresses the breast between two plates for a few seconds at a time and captures images from different angles. It is the most established and best-studied breast cancer screening tool in medicine.

- **Time on site:** 20 to 45 minutes, most of which is paperwork and changing
- **Actual imaging time:** 10 to 15 minutes
- **Anesthesia:** none, you are awake and standing
- **Discomfort:** brief pressure during compression, usually 5 to 10 seconds per image
- **Radiation dose:** very low, roughly equivalent to seven weeks of natural background radiation
- **Results:** typically available within a few days to a week

There are two big distinctions that drive billing and cost. The first is **screening versus diagnostic**. Screening is for people with no symptoms, done on a regular schedule. Diagnostic is for people with a lump, pain, nipple discharge, or an abnormal screening result that needs a closer look.

The second is **2D versus 3D (tomosynthesis)**. Standard 2D takes flat images. 3D takes multiple thin slices, which can reduce callbacks and improve detection in dense breast tissue.

These distinctions matter because Medicare pays them as separate codes, insurance covers them differently, and 3D is often billed as an add-on to 2D rather than as a replacement.

## When it is done

Mammography is used in two very different situations, and the distinction matters for both your care and your bill.

Your doctor may recommend this when:

1. You are age 40 or older and due for your annual or biennial screening under USPSTF, ACS, or your insurer's guidelines
2. You have a family history or genetic risk (BRCA1, BRCA2) and need earlier or more frequent screening
3. You feel a new lump, thickening, or change in breast tissue
4. You have unexplained nipple discharge, skin changes, or persistent breast pain
5. An earlier screening mammogram showed something that needs a closer look (a callback)
6. You are being followed after a prior breast cancer diagnosis or biopsy

Breast MRI is used for high-risk patients (BRCA carriers, very dense breasts) alongside mammography, not as a replacement. Breast ultrasound is often used to clarify a specific finding from a mammogram or to evaluate a palpable lump, especially in younger women with dense tissue. None of these tools replace mammography for population screening.

If you've been called back after a screening, that does not mean you have cancer. Most callbacks turn out to be benign. But the visit itself shifts from screening (free under most plans) to diagnostic (cost-shared), and that often surprises patients.

## What you pay

The gap between Medicare and commercial pricing on mammography is real but smaller than on surgical procedures. Medicare pays about $52 on average across variants, with 2D screening at $69 and 3D at $35 (billed together). Commercial insurance typically pays imaging centers $150 to $300 per study, and hospital-based imaging departments can negotiate $400 or more. Cash prices at freestanding centers often undercut commercial rates.

The good news for most women: annual screening mammograms are covered at **$0 out of pocket** on ACA-compliant commercial plans and Medicare, with no deductible and no coinsurance. The bad news: that protection evaporates the moment the visit becomes diagnostic.

**If you're on Medicare:**

- Annual screening mammograms (77067) and 3D screening (77063) are covered at 100% under Part B with no deductible
- Diagnostic mammograms (77065, 77066) are subject to the Part B deductible ($257 in 2025 figure) and 20% coinsurance
- Medigap or Medicare Advantage can cover that 20% share depending on your plan
- If you have Original Medicare without a supplement, budget roughly $15 to $30 out of pocket for a diagnostic study

**If you have commercial insurance:**

- ACA-compliant plans cover annual screening at $0, no deductible, no copay; this includes 3D tomosynthesis on most major carriers
- Diagnostic mammograms are usually cost-shared under your deductible and coinsurance, which can mean $100 to $400 out of pocket early in the plan year
- Several states (New York, Illinois, Texas, and others) have passed laws requiring $0 cost sharing for diagnostic mammograms as well; check your state
- High-deductible health plans often charge full price for diagnostic until the deductible is met

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

- Cash-pay rates at freestanding imaging centers typically run $100 to $250 for a 2D screening and $150 to $350 with 3D
- The CDC's National Breast and Cervical Cancer Early Detection Program offers free or low-cost screening for eligible women in every state
- Nonprofits like Susan G. Komen, YWCA, and local hospital foundations run free screening events, especially in October (Breast Cancer Awareness Month)
- Always ask for the cash-pay rate directly; it is frequently lower than the billed price to insurance

## Anatomy of the bill

The bill has multiple line items. Understanding each one helps you catch errors and avoid surprise charges.

- **Technical / facility fee:** The charge for the equipment, the room, the technologist's time, and the facility overhead. This is the single largest line item. It varies the most by setting: hospital outpatient departments bill significantly more than freestanding imaging centers for the same study.

- **Professional interpretation fee:** The radiologist's fee for reading the images and writing the report. Billed separately even though you never meet the radiologist. Runs $30 to $80 for Medicare and $60 to $150 for commercial insurance.

- **3D tomosynthesis add-on:** If you get 3D imaging, it's billed as a separate code (77063 for screening, other codes for diagnostic) stacked on top of the 2D study. Adds roughly $35 to Medicare and $50 to $100 to commercial bills.

- **Screening vs diagnostic coding:** Not an extra charge, but the single biggest driver of your out-of-pocket cost. Screening codes (77067, 77063) are typically free. Diagnostic codes (77065, 77066) are cost-shared. If you came in for screening and left with diagnostic coding, ask why.

- **Contrast material:** Not used in standard mammography. If you see a contrast line item on a mammogram bill, it's likely an error or a different study (contrast-enhanced mammography is a newer, specialized test).

- **Ultrasound or biopsy (separate visit):** If the radiologist wants a closer look, you may be called back for a targeted ultrasound or biopsy. These are distinct studies with their own billing and are almost always diagnostic and cost-shared.

## Cost by state

State-level payment data reveals a meaningful price range. **Maryland** is the priciest state in the Medicare data at $73 per service on average, followed by Alaska ($63), Rhode Island ($62), Arizona ($61), and Nevada ($61). **West Virginia** is the cheapest at $34, with Vermont ($35), Ohio ($36), Oklahoma ($37), and Maine ($38) close behind. **California**, **Florida**, and **Texas** dominate total volume with more than 5.5 million, 5.5 million, and 3.8 million services respectively, reflecting large Medicare populations.

The range of roughly 2x between the cheapest and priciest states understates the commercial-side variation, which can be 5x or wider within the same metro area.

Why costs vary by state:

- **Medicare GPCI adjustments:** Medicare scales payments by geographic practice cost index, so high cost-of-living metros (DC, NYC, San Francisco, Boston) pay more
- **Facility mix:** States dominated by hospital-owned imaging tend to have higher average payments than states with many independent freestanding centers
- **Commercial negotiation leverage:** Large hospital systems in some markets (especially the Northeast and California) command higher commercial rates
- **State cost-sharing laws:** Some states mandate $0 cost sharing on diagnostic mammograms, which affects patient out-of-pocket but not the underlying billed amount

## Office vs facility

Mammography volume splits roughly evenly: 6.3 million facility services versus 6.6 million office services in the Medicare data. The price gap, though, is dramatic. Office-setting Medicare payment averages $70 while facility-setting averages $32. Office billing bundles technical and professional fees into a single global charge; facility billing splits them. The facility separately bills its technical fee, which Medicare pays on a different schedule.

For commercial patients, the real practical choice is usually **hospital-based imaging department versus freestanding imaging center**. Both can do 2D and 3D, both use the same FDA-regulated equipment, and both must hold MQSA certification.

When hospital-based imaging makes sense:

- You want same-day diagnostic workup (ultrasound or biopsy) if something shows up
- You are already part of a hospital system where all your records live
- You need complex breast imaging (MRI, contrast-enhanced) that freestanding centers may not offer

When a freestanding center makes sense:

- You want the lowest out-of-pocket cost, especially if you're paying cash or have a high deductible
- You only need routine screening with no history of breast issues
- You value shorter wait times and easier parking

## Who performs the procedure

Mammography is overwhelmingly performed and interpreted by **diagnostic radiologists**, who account for roughly 94% of all providers in the Medicare data (10,861 of about 15,000). Interventional radiology contributes a small share. OB/GYN, family practice, and internal medicine practices appear in the data mostly because they own or lease imaging equipment and bill for the facility-technical component, not because the doctor themselves reads the images.

- **FDA-certified facility** under the Mammography Quality Standards Act (MQSA); this is legally required but worth verifying on the FDA's MQSA search
- **ACR accreditation** from the American College of Radiology for both the facility and the radiologists
- **Breast imaging fellowship** or significant subspecialty focus in the reading radiologists; breast fellowship-trained radiologists detect more cancers at lower callback rates
- **Volume:** centers reading more than a few thousand studies per year develop stronger pattern recognition
- **3D tomosynthesis availability,** especially if you have dense breast tissue
- **Same-day diagnostic workup** capability, so that a callback finding can be evaluated during one visit rather than across multiple appointments

A note on low-volume specialties: general surgery (54 providers), nurse practitioner (302), and physician assistant (142) appear in the data but these clinicians do not primarily read mammograms. The billing reflects supervision or office-based facility arrangements rather than image interpretation. The person actually reading your images will, in almost every case, be a radiologist.

## How to shop for the best price

Mammography is one of the easier imaging studies to shop for because facilities are standardized, quality is regulated, and most markets have several options within a short drive.

1. **Confirm screening versus diagnostic coding before you walk in.** Ask the ordering provider which CPT code will be billed. If it's 77067 or 77063 (screening), it should be free under most plans. If it's 77065 or 77066 (diagnostic), you'll owe your share.

2. **Request a Good Faith Estimate if paying cash.** Federal law (the No Surprises Act) requires facilities to give uninsured or self-pay patients a written estimate before the visit.

3. **Call three imaging centers.** Ask for the cash-pay rate and the self-pay discount. You will often find a 2x to 3x range within 20 miles.

4. **Verify in-network status for both the facility AND the reading radiologist group.** Radiologist groups frequently bill separately and may be out-of-network even at an in-network facility. This is a common surprise billing source.

5. **Ask whether 3D is included in the screening charge or billed as an add-on.** Under ACA, commercial plans generally cover 3D screening at $0 in addition to 2D, but a minority of plans and states still have gaps.

6. **Use free or low-cost screening programs if you're uninsured.** The CDC's National Breast and Cervical Cancer Early Detection Program operates in every state. Many hospital foundations run free screening days, especially in October.

7. **Keep your prior images.** Bring a disk or arrange electronic transfer of prior mammograms so the radiologist can compare year over year. This reduces callbacks and avoids repeat imaging.

Red flags to watch for: vague quotes that bundle screening and diagnostic into the same price, estimates that don't separate technical from professional fees, and facilities that won't give you a cash rate in writing. If you had a $0 screening last year and are suddenly being quoted $300 for the same study, ask what changed in the coding.

## Surprise billing risks

Surprise billing on mammography most often comes from two places: the radiologist interpretation fee being out-of-network when the facility is in-network, and a screening visit quietly getting recoded as diagnostic.

Most common surprise-billing sources:

- **Out-of-network radiologist at an in-network facility,** especially at hospital-owned imaging where the radiology group contracts separately
- **Screening reclassified as diagnostic** because the technologist or radiologist noted a finding that required additional views during the same visit
- **Callback appointments billed as diagnostic** when the patient assumed they'd still be covered as screening
- **3D tomosynthesis charged separately** on older insurance plans that haven't updated their coverage rules for 77063
- **Facility fees added** at hospital outpatient departments that weren't disclosed in the quoted price

If you get a surprise bill:

- Don't pay until you've verified every charge. Request a fully itemized bill showing each CPT code and the billed amount.
- Compare the codes against the ordering doctor's referral. If you were referred for screening (77067) and billed for diagnostic (77065 or 77066), ask why.
- File a No Surprises Act complaint at cms.gov/nosurprises if an out-of-network provider billed you at an in-network facility. The 2022 federal law gives you access to arbitration.
- Contact your state insurance commissioner if your state has its own mammogram cost-sharing protections.
- Ask the facility's patient financial services office about charity care, sliding-scale programs, or cash-pay renegotiation.

## Total recovery cost

Mammography has no recovery in the traditional sense. You walk out, go back to work, and do whatever you had planned. Some women have brief breast tenderness from compression that resolves within hours to a day. There are no restrictions on activity, driving, or lifting.

The real budget considerations aren't recovery costs, they're downstream costs if your mammogram finds something that needs further evaluation.

- **Diagnostic callback visit:** $100 to $400 out of pocket under most commercial plans if you are called back after a screening finding
- **Targeted breast ultrasound:** $100 to $500 depending on facility and insurance, typically ordered alongside diagnostic mammography
- **Breast MRI (if high-risk or indeterminate findings):** $500 to $3,000 before insurance, commonly cost-shared
- **Image-guided biopsy (core needle or stereotactic):** $1,000 to $5,000 before insurance
- **Pathology fee on any biopsy tissue:** $200 to $600 billed separately from the biopsy procedure itself
- **Time off work:** minimal for the screening itself, but budget half a day for diagnostic workup or biopsy
- **Genetic testing (if family history prompts it):** $250 to $2,000 depending on panel and insurance coverage

For most women, the realistic total cost of a routine screening year is exactly $0 under an ACA-compliant plan or Medicare. The episode gets expensive only when a callback cascades into ultrasound, MRI, or biopsy. About 10% of screening mammograms generate a callback, and fewer than 1% ultimately find cancer, but that first callback often means the patient moves from the $0 column to a several-hundred-dollar column quickly.

## Variants of this procedure

- 3D Screening Mammogram (Tomosynthesis Add-On)
- Diagnostic Mammogram (One Breast)
- Diagnostic Mammogram (Both Breasts)
- Screening Mammogram (2D)

## Frequently asked questions

### How much does a mammogram cost with insurance?

An annual screening mammogram is covered at $0 out of pocket under ACA-compliant commercial plans and Medicare, with no deductible or copay. A diagnostic mammogram, typically ordered for symptoms or after a screening callback, is usually cost-shared under your deductible and coinsurance and can run $100 to $400 out of pocket early in the plan year.

### Does Medicare cover mammograms?

Yes. Medicare Part B covers one annual screening mammogram (plus 3D tomosynthesis) at $0 out of pocket for women 40 and older, with no deductible. Diagnostic mammograms are covered but are subject to the Part B deductible ($257 in 2025 figure) and 20% coinsurance, which Medigap or Medicare Advantage may pick up.

### What's the difference between a 2D and 3D mammogram?

A 2D mammogram (77067) takes flat images from a few angles. A 3D mammogram, also called tomosynthesis (77063), takes multiple thin slices that the radiologist can scroll through. 3D reduces callbacks and improves cancer detection in dense breasts. It's billed as a small add-on ($35 Medicare, usually $0 patient cost on ACA plans) on top of the 2D code rather than as a replacement.

### What's the difference between screening and diagnostic mammograms?

Screening is for women with no symptoms, done on a regular schedule and covered at $0 on most plans. Diagnostic is for women with a lump, pain, discharge, or a callback from a screening, and it uses different CPT codes (77065 for one breast, 77066 for both) that are typically cost-shared. The actual machine and images can look the same, but the billing rules change completely.

### How do I avoid a surprise bill from a mammogram?

Confirm the CPT code being ordered (screening versus diagnostic) before the visit, verify that both the facility and the radiologist group are in-network with your plan, and ask whether 3D is billed as an add-on. If you're called back for additional imaging, expect to move from $0 to cost-shared status, and ask the facility for a Good Faith Estimate in writing.

### What's the cheapest way to get a mammogram?

For insured patients with ACA-compliant plans, annual screening is already free. For uninsured patients, cash rates at freestanding imaging centers usually run $100 to $250 for 2D and $150 to $350 with 3D. The CDC's National Breast and Cervical Cancer Early Detection Program offers free or reduced-cost screening in every state. Hospital foundations and nonprofits run free screening events, especially in October.

### How long does a mammogram take?

The imaging itself takes 10 to 15 minutes. Total time on site, including paperwork and changing, is usually 20 to 45 minutes. You walk out and resume normal activity immediately, though some women have brief breast tenderness from compression. Results are typically available within a few days to a week.

### Where does this cost data come from?

Medicare payment figures come from the CMS Medicare Physician & Other Practitioners by Provider and Service public use file, covering 13 million services across more than 15,000 providers. Commercial, cash, and out-of-pocket figures are ranges based on published industry benchmarks and hospital price transparency data, not specific negotiated rates, because those vary by plan and market.

## 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)