Hospital-owned imaging
Mammogram performed at a hospital outpatient facility or hospital-owned breast center.
Price risk: Facility fees can substantially raise the allowed amount.
Find out what healthcare may actually cost before you book
Mammogram Cost in the USA: Cash Price vs Insurance Price
Compare cash and insurance pricing for a mammogram, with the screening-vs-diagnostic distinction that determines whether the procedure is covered as ACA preventive care at no patient cost.
Peter Langdon · TreatCompare editor — healthcare price research
Important information for US visitors
This page is general consumer information about US hospital price-transparency data and shoppable-service pricing. It is not insurance advice, billing advice, legal advice, tax advice, or medical advice, and it is not a substitute for an insurance broker, patient advocate, certified medical biller, or attorney. The cash-vs-insurance calculator produces scenario estimates only, based on numbers you enter; an actual bill depends on your plan, network status, prior authorisation, separate professional and facility fees, and the specific procedure code billed. Please verify any quoted price and your estimated patient responsibility directly with your provider and your insurer before booking care.
Could paying cash for a mammogram be cheaper than using insurance?
Paying cash for an Mammogram can be cheaper than using insurance when the cash quote is below your likely patient responsibility under insurance. The key comparison is not cash price vs sticker price; it is cash price vs your deductible, coinsurance, copay and out-of-pocket maximum.
Screening vs diagnostic
Critical
A screening mammogram may be a $0 ACA-preventive service; a diagnostic mammogram is not.
Key billing code
CPT code
Screening, diagnostic and 3D (tomosynthesis) mammograms use different CPT codes and prices.
Main hidden issue
3D upcharge
Tomosynthesis (3D mammography) is sometimes billed as an add-on that the plan does not cover the same way as the base screening.
Decision tool
Should I pay cash or use insurance for an Mammogram?
Cash route
$180
Insurance estimate
$280
Current signal
Cash looks cheaper by $100
This is a simple estimate. It does not verify network status, prior authorization, separate radiologist bills, contrast, facility fees, or whether a cash payment counts toward your plan deductible or out-of-pocket maximum.
Independent imaging center
Freestanding imaging provider; often the cheapest cash option.
Price risk: Confirm the radiologist read is included.
OB / GYN office
In-office mammography in a primary care or OB/GYN setting.
Price risk: Check whether mammography is billed alongside an office visit.
What changes an Mammogram bill?
The useful comparison is itemised. These are the fields to pin down before relying on any quote.
| Factor | Why it matters | What to ask |
|---|---|---|
| Screening vs diagnostic intent | ACA preventive rules cover screening mammograms at no cost-sharing; diagnostic mammograms are not protected. | Ask whether the mammogram will be billed as screening or diagnostic. |
| 2D vs 3D (tomosynthesis) | 3D imaging often carries a separate add-on charge that may or may not be covered as preventive. | Ask whether 3D will be performed and how it is billed. |
| Facility setting | Hospital-owned imaging centers may charge more than independent imaging centers. | Confirm where the scan is performed and whether facility fees apply. |
| Radiologist read | The radiologist interpretation may be a separate professional fee. | Ask whether the quote includes the read. |
| Network status | Out-of-network imaging can be billed at much higher allowed amounts. | Confirm in-network status for your exact plan. |
Example cash vs insurance scenarios
These are illustrative calculations only. Replace them with your plan and provider quote in the tool above.
| Scenario | Cash quote | Allowed amount | Deductible left | Coinsurance | Insurance estimate | Signal |
|---|---|---|---|---|---|---|
| Screening, ACA preventive | $180 | $280 | $0 | 0% | $0 | Insurance should be $0 if billed correctly as ACA preventive screening. |
| Diagnostic, high deductible | $180 | $280 | $500 | 20% | $280 | Cash may be cheaper for diagnostic mammograms with a high remaining deductible. |
| Diagnostic, deductible met | $180 | $280 | $0 | 20% | $56 | Insurance is usually cheaper once the deductible is met. |
Common Mammogram CPT codes
The CPT code changes the comparison. Ask the ordering clinician or imaging provider which code will be billed.
| Code | Description | Typical use |
|---|---|---|
| 77067 | Screening mammography, bilateral | Routine breast cancer screening for asymptomatic patients. |
| 77066 | Diagnostic mammography, bilateral | Workup of breast symptoms, abnormal screening result. |
| 77065 | Diagnostic mammography, unilateral | Workup of a single-side abnormality. |
| 77063 | Screening digital breast tomosynthesis, bilateral | Add-on 3D component to bilateral screening mammogram. |
Seed price records
Provider-specific rows appear only after source checks.
No provider-specific Mammogram price records are published in this MVP yet. This is deliberate: the template is ready for CMS hospital MRF rows, hospital shoppable-service rows and independent provider cash prices, but TreatCompare should not display nationwide prices until each row has a source URL, checked date and confidence rating.
Questions to ask before booking
- Is this screening or diagnostic mammography?
- Will 3D (tomosynthesis) be performed, and how is it billed?
- Is the radiologist read included in the quote?
- Is there a separate facility fee?
- If I pay cash, will the payment count toward my deductible or out-of-pocket maximum?
- What is my estimated patient responsibility if billed to my insurance?
- Is this provider in network for my exact plan?
Data-source caveats
- TreatCompare has not yet ingested nationwide hospital MRF rows for mammography.
- ACA preventive-care rules can make a screening mammogram $0 to the patient; diagnostic mammograms are subject to cost-sharing.
- 3D mammography (tomosynthesis) coding and coverage varies by plan.
- A payer-specific negotiated charge is not the same as the patient out-of-pocket amount.
Using this data?
Methodology, extracts and licensing
Main sources
- CMS Hospital Price Transparency overview
- CMS Hospital Price Transparency hospitals page
- CMSgov/hospital-price-transparency GitHub repository
- CMS CSV/JSON data dictionary and template guidance
Methodology: TreatCompare maps CMS standard-charge fields and provider cash-price fields into a consumer comparison model. This MVP explains the decision logic before full hospital MRF ingestion.
TreatCompare publishes healthcare, care-cost and treatment-pricing research for consumers, journalists, policymakers and commercial teams.
Contact TreatCompare about dataMethodology, source summaries and structured extracts: data@treatcompare.com
Cash price vs insurance price
The broader decision guide for US healthcare prices
Methodology
How we label CMS, cash-pay and insurance price fields