Paying for a mammogram in the US
Screening or diagnostic breast imaging, including tomosynthesis. Four routes can pay for it: Original Medicare, Medicaid, employer or Marketplace insurance, and paying the provider yourself. The table sets out what each route covers and the price, with the source of every figure and the date it was read. Where a route publishes nothing, or this site has not read it, the cell says so.
How each route pays for a mammogram
| Route | What it covers | Wait | Payment or price | Source |
|---|---|---|---|---|
| Original Medicare (Part B)CPT 77067: Screening mammography bilateral | Not trackedCPT 77067 is a screening code. Medicare’s cost-sharing for preventive screening has not been read, so the general Part B share is not applied to it here | Not publishedNo official US source publishes waiting times for elective care | $126.26What Medicare pays for the whole service in an office or imaging center, national amount before geographic adjustment. Not a patient price. |
|
| MedicaidRun by each state within federal rules | Not trackedCoverage is set by each state; no state’s Medicaid rules for mammogram have been read | Not publishedNo official US source publishes waiting times for elective care | Not trackedNo state Medicaid payment or cost-sharing has been read | None for this row |
| Employer or Marketplace insuranceAs a mechanism; no insurer, plan or premium is named | Set by each plan’s terms71% of workers with employer coverage are in self-funded plans (KFF Employer Health Benefits Survey 2026), where the employer pays claims from its own funds. | Not publishedNo official US source publishes waiting times for elective care | Up to $10,600 a yearFederal cap on in-network cost-sharing for an individual on a Marketplace plan, plan year 2026 (family: $21,200). Excludes premiums, services the plan does not cover and out-of-network care. |
|
| Self-pay at a hospitalDiscounted cash price, CPT 77067, facility charge | The hospital’s facility charge for the service; professional fees are a separate billing class, not includedYou are entitled to a Good Faith Estimate of expected charges when you book or ask (45 CFR 149.610) | Not publishedNo official US source publishes waiting times for elective care | $298Median of 36 hospitals’ published cash prices, $58–$2,388. Files read 26 October 2026. |
|
- Waits: no official US source publishes waiting times for elective care, so none is shown for any route.
- The Part B deductible is $283 for calendar year 2026 (CMS: 2026 Medicare Parts A & B Premiums and Deductibles, read 26 October 2026). The patient's share is not calculated here: it depends on the deductible already paid, the setting, and any separate facility charge.
- For plan choice within Medicare, including any plan other than Original Medicare, see Medicare.gov. TreatCompare does not name, compare or price plans.
- Figures from different routes are not added together or compared as one bill. What Medicare pays, an insurance cap and a provider's self-pay price each describe a different thing.
Every billing code for a mammogram, one at a time
Each billing code is a different service at its own price, so codes are never averaged together. This is what Medicare pays under its national fee schedule, before geographic adjustment. It is not a price charged to patients or to anyone without Medicare. Hospital cash prices and negotiated rates are separate figures from the same files: the first is what the hospital charges a self-pay patient, the second what insurers have agreed to pay it, shown with no payer named.
| Code and service | What Medicare pays: office | What Medicare pays: clinician, in a facility | Hospital cash price | Hospital negotiated rates |
|---|---|---|---|---|
| 77067Screening mammography bilateral | $126.26 | Not applicable in this setting | $298median of 36 hospitals, $58–$2,38814 more list several charge lines and are not counted | $187median of 37 hospitals, $86–$881; rates from 613 payer–hospital pairs, no payer named13 more list several charge lines and are not counted |
| 77066Diagnostic mammography bilateral | $156.98 | Not applicable in this setting | $410median of 43 hospitals, $71–$2,4486 more list several charge lines and are not counted | $221median of 44 hospitals, $103–$1,094; rates from 1,029 payer–hospital pairs, no payer named5 more list several charge lines and are not counted |
| 77065Diagnostic mammography unilateral | $123.92 | Not applicable in this setting | $348median of 40 hospitals, $57–$2,0327 more list several charge lines and are not counted | $176median of 43 hospitals, $81–$867; rates from 1,006 payer–hospital pairs, no payer named6 more list several charge lines and are not counted |
| 77063Screening digital breast tomosynthesis bilateral | $51.10 | Not applicable in this setting | $84median of 40 hospitals, $13–$8679 more list several charge lines and are not counted | $55median of 42 hospitals, $22–$331; rates from 736 payer–hospital pairs, no payer named9 more list several charge lines and are not counted |
| G0279Diagnostic digital breast tomosynthesis (Medicare add-on) | $40.42 | Not applicable in this setting | $63median of 19 hospitals, $15–$32210 more list several charge lines and are not counted | $41median of 38 hospitals, $13–$22,145; rates from 381 payer–hospital pairs, no payer named10 more list several charge lines and are not counted |
- Medicare amounts: CMS Physician Fee Schedule relative value file RVU26D, read 26 October 2026. Service labels are TreatCompare's plain-English wording, not CMS or AMA descriptors.
- Hospital figures are facility charges from each hospital's own standard-charge file. A hospital whose file lists several different charge lines for one code is named but not counted, because no single line is the service. Hospitals on one file host publishing the same figure count once.
The hospital files behind the self-pay figure (CPT 77067)
Each hospital's discounted cash price for CPT 77067 (Screening mammography bilateral), from its own file, A to Z, with the date the file was read.
| Hospital | State | Cash price | File |
|---|---|---|---|
| AdventHealth Orlando | FL | $784 | Standard-charge fileread 26 October 2026 |
| Advocate Christ Medical Center | IL | $238 | Standard-charge fileread 26 October 2026 |
| Banner - University Medical Center Phoenix | AZ | $310 | Standard-charge fileread 26 October 2026 |
| Beaumont Hospital Royal Oak | MI | $609 | Standard-charge fileread 26 October 2026 |
| Cleveland Clinic Florida | FL | $495 | Standard-charge fileread 26 October 2026 |
| Cleveland Clinic Main Campus | OH | $396 | Standard-charge fileread 26 October 2026 |
| Denver Health Medical Center | CO | $58 | Standard-charge fileread 26 October 2026 |
| Duke University Hospital | NC | $108 | Standard-charge fileread 26 October 2026 |
| Erlanger Baroness Hospital | TN | $235 | Standard-charge fileread 26 October 2026 |
| Froedtert Hospital | WI | $376 | Standard-charge fileread 26 October 2026 |
| Grady Memorial Hospital | GA | $749 | Standard-charge fileread 26 October 2026 |
| Hennepin Healthcare | MN | $182 | Standard-charge fileread 26 October 2026 |
| HonorHealth Scottsdale Shea Medical Center | AZ | $725 | Standard-charge fileread 26 October 2026 |
| Hospital of the University of Pennsylvania | PA | $2,388 | Standard-charge fileread 26 October 2026 |
| Houston Methodist Hospital | TX | $333 | Standard-charge fileread 26 October 2026 |
| INTEGRIS Baptist Medical Center | OK | $147 | Standard-charge fileread 26 October 2026 |
| Lovelace Medical Center | NM | $165 | Standard-charge fileread 26 October 2026 |
| M Health Fairview University of Minnesota Medical Center | MN | $188 | Standard-charge fileread 26 October 2026 |
| Memorial Medical Center Las Cruces | NM | $452 | Standard-charge fileread 26 October 2026 |
| MetroHealth Medical Center | OH | $183 | Standard-charge fileread 26 October 2026 |
| MUSC Health University Medical Center | SC | $276 | Standard-charge fileread 26 October 2026 |
| North Memorial Health Hospital | MN | $243 | Standard-charge fileread 26 October 2026 |
| Novant Health Forsyth Medical Center | NC | $195 | Standard-charge fileread 26 October 2026 |
| ProMedica Toledo Hospital | OH | $398 | Standard-charge fileread 26 October 2026 |
| Providence St. Vincent Medical Center | OR | $336 | Standard-charge fileread 26 October 2026 |
| Saint Francis Hospital Tulsa | OK | $211 | Standard-charge fileread 26 October 2026 |
| Stanford Hospital | CA | $287 | Standard-charge fileread 26 October 2026 |
| Tampa General Hospital | FL | $203 | Standard-charge fileread 26 October 2026 |
| The Johns Hopkins Hospital | MD | $1,288 | Standard-charge fileread 26 October 2026 |
| The Mount Sinai Hospital | NY | $720 | Standard-charge fileread 26 October 2026 |
| Thomas Jefferson University Hospital | PA | $109 | Standard-charge fileread 26 October 2026 |
| UCHealth University of Colorado Hospital | CO | $368 | Standard-charge fileread 26 October 2026 |
| UnityPoint Health Iowa Lutheran HospitalSame figure, same file host: UnityPoint Health Iowa Methodist Medical Center | IA | $327 | Standard-charge fileread 26 October 2026 |
| University of Iowa Hospitals & Clinics | IA | $375 | Standard-charge fileread 26 October 2026 |
| UofL Health Jewish Hospital | KY | $183 | Standard-charge fileread 26 October 2026 |
| UT Southwestern University Hospitals | TX | $260 | Standard-charge fileread 26 October 2026 |
Not counted, because the file lists several charge lines for this code: Abbott Northwestern Hospital (MN, 3 lines); Aurora St. Luke's Medical Center (WI, 2 lines); Corewell Health Butterworth Hospital (MI, 3 lines); Legacy Emanuel Medical Center (OR, 2 lines); Mercy Hospital Oklahoma City (OK, 3 lines); Mercy Hospital St. Louis (MO, 2 lines); MercyOne Des Moines Medical Center (IA, 3 lines); Norton Children's Hospital (KY, 2 lines); OU Health University of Oklahoma Medical Center (OK, 5 lines); Saint Francis Hospital and Medical Center (CT, 2 lines); Sentara Norfolk General Hospital (VA, 2 lines); Swedish Medical Center First Hill (WA, 2 lines); University of Chicago Medical Center (IL, 2 lines); Wellstar Kennestone Regional Medical Center (GA, 2 lines).
Paying yourself: the Good Faith Estimate
Providers and facilities must give uninsured and self-pay patients a Good Faith Estimate of expected charges when a service is scheduled or on request.
Source: eCFR: 45 CFR 149.610, In force (45 CFR 149.610, text as of 2026-10-01), read 26 October 2026.
More on a mammogram in the US
Sources
- CMS Physician Fee Schedule relative value file RVU26D, 2026 national amounts. Read 26 October 2026. What Medicare pays, national amounts, per code.
- CMS: 2026 Medicare Parts A & B Premiums and Deductibles, Calendar year 2026. Read 26 October 2026. Part B annual deductible.
- eCFR: 45 CFR 149.610, In force (45 CFR 149.610, text as of 2026-10-01). Read 26 October 2026. The Good Faith Estimate rule.
- KFF: 2026 Employer Health Benefits Survey, KFF Employer Health Benefits Survey 2026. Read 26 October 2026.
- HealthCare.gov glossary: out-of-pocket maximum/limit, Plan year 2026. Read 26 October 2026.