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CostHelper > Health & Personal Care  > Reproductive Health > Mammogram

Mammogram Cost

How Much Does a Mammogram Cost?

average costWith Insurance coverage: No Charge or Copayhigh costWithout Insurance: $80-$212
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A mammogram is a breast X-ray used for early detection of breast cancer. It is recommended yearly starting at age 40. A clinical breast examination, in which a doctor or nurse examines the breast for lumps or irregularities, is recommended once every three years starting at age 20, then once a year at age 40 and up.

Typical costs:

  • For an uninsured patient, typical full-price cost of a mammogram ranges from $80 to $120 or more, with an average of about $102, according to Blue Cross Blue Shield of North Carolina. Some providers charge more, and some offer an uninsured discount. For example, at the Kapiolani Medical Center[1] in Aiea, Hawaii, where the full price is about $212, an uninsured patient would pay about $127 to $148.
  • Mammograms usually are covered by health insurance for women in the recommended age bracket. Many states require health insurance companies to cover regular mammograms, usually after age 40. The National Women's Law Center offers a state-by-state chart.
  • For women covered by health insurance, some plans require no out-of-pocket expenses, while others charge a copay, generally between $10 and $35.
  • A clinical breast exam is much less expensive, and usually is included as part of a general or gynecological check-up.
Related articles: Pap Test, Colonoscopy, Hemorrhoid Treatment, Flu Shot

What should be included:
  • The mammogram technician places the breast between two plastic plates, which compress the breast tissue so a clear X-ray can be taken. The procedure takes about 20 minutes.
  • The American Cancer Society[2] offers a primer on early detection of breast cancer. Only two to four of every 1,000 women who undergo a mammogram end up receiving a diagnosis of cancer.
  • In a clinical breast exam, the doctor or nurse manually checks the breasts, lymph nodes and nipples for any palpable irregularities.
Additional costs:
  • Women at high risk for breast cancer, such as those with a known breast cancer gene mutation, should consider getting an MRI each year in addition to a mammogram, according to the American Cancer Society.
  • If an irregularity is found, more testing or follow-up testing might be required. About 10 percent of women who have a mammogram require more tests, usually just another mammogram. However, about 8 to 10 percent do require a biopsy.
  • During the month of October, Breast Cancer Awareness Month, some community or women's groups offer free or very low-cost mammograms, sometimes using a mobile clinic. To find a program, call the Susan G. Komen for the Cure Breast Care Helpline at 1-800 I'M AWARE (1-800-462-9273). Or contact the YWCA's ENCOREplus[3] program any time for a referral for a free or low-cost mammogram.
  • Visit the U.S. Centers for Disease Control and Prevention website to find a program in your area that offers low-cost or free mammograms to uninsured and underinsured women who qualify.
Shopping for a mammogram:
  • If you have health insurance, consult with your general practitioner or gynecologist to get a mammogram and/or a clinical breast exam.
  • Otherwise, check with your local Susan G. Komen for the Cure affiliate to get more information on planned screening events. Or, call your local health department or use the Planned Parenthood Federation of America, Inc.[4] 's online search feature to find a local clinic.
  • For mammorgrams, the American Cancer Society recommends using a facility that performs many mammograms each day, and is authorized by the U.S. Food and Drug Administration to perform mammograms.
Material on this page is for informational purposes only and should not be construed as medical advice. Always consult your physician or pharmacist regarding medications or medical procedures.
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What People Are Paying - Recent Comments

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Cost of mammogram
Amount: $901.81
Posted by: MLS765 in Batesville, IN, IN.Posted: May 20th, 2015 08:05AM
Clinic or Doctor: Margaret Mary HospitalInsurance Carrier: Blue Cross Blue Shield
Type of Policy: PPO
Bill was 1196.01, BCBS said they could only charge 901.81. Really?? I pay $2000 a year for insurance and this is it. It was CONSIDERED a diagnostic mammogram because I turned 40 and my OB/GYN said I needed to have one.
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Amount: $0.00
Posted by: ss2104 in Boson, MA.Posted: April 20th, 2015 12:04PM
Clinic or Doctor: Insurance Carrier: BCBS Massachusetts
Mine cost me zero this year because I'm not doing it every year. I don't smoke, not overweight, no family history. The clinic I go to apparently needs "rich" customers to support all those getting free health insurance living in free housing in my city. With my $30 copay and $2000 deductible I can't see donating money for a device with a shoddy record of finding cancer early on.
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Digital Mammography - NOT COVERED
Amount: $550.00
Posted by: Taking Polaroids next time in Jacksonville, FL.Posted: January 25th, 2015 06:01PM
Clinic or Doctor: Baptist SouthInsurance Carrier: BCBS FL
Type of Policy: PPO
The $550 was for the mammogram. That amount does not include the radiologist reading it, facility fees, etc. The archaic mammogram -- the one that takes the bad pictures that don't distinguish between "normal margins" and "bad-news bad margins" are free. Oh, the digital came back negative for any cancer and positive for WTH!!!!! But hey - Cancer treatment is covered.
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3 D Mammography Not Covered
Amount: $492.00
Posted by: Sue T in Oconomowoc, WI.Posted: December 4th, 2014 06:12AM
Clinic or Doctor: Oconomowoc Memorial HospitalInsurance Carrier: Humana
Type of Policy: PPO
Beware of your policy terms if you have 3D mammography. My plan, through my employer, does not cover "new, unproven technology", so will not cover a 3D mammogram unless medically indicated. My Dr. ordered the mammogram at the hospital, where there is only one machine. It is a 3D machine. Unless I knew this, and asked my Dr. if there was somewhere else to go to get a regular mammogram, then I am stuck with the charge.
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Cost of Annual Mamograms
Amount: $1,014.97
Posted by: elizabeth cahill in Baltimore, MD.Posted: November 18th, 2014 01:11PM
Clinic or Doctor: John Hopkins Med CenterInsurance Carrier: Cigna
Type of Policy: Consumer Choice
Had routine mammogram then an ultrasound ( needed a better reading). Insurance first said they would not pay because it was coded Diagnostic. After several conversations with Johns Hopkins and Cigna, Cigna said it was because I had not reached my deductible of 1500. I was charged 417.93 for mamogram and 597.04 for ultrasound. I am responsible for 868.69 which doesn't include the Doctor's portion of the bill.
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Mammo, Follow Up Mammo, and Ultrasound - RIPOFF REPORT HERE ALSO
Amount: $2,157.50
Posted by: Kelly D in Denver, CO.Posted: October 22nd, 2014 12:10PM
Clinic or Doctor: PSL Medical CenterInsurance Carrier: Cigna
Type of Policy: HDP
Please beware of Presbyterian St. Lukes Medical Center in Denver, CO. Please make sure your mammo and follow up are marked preventative. If it is marked diagnostic your insurance will NOT PAY!!!!
Routine Mammo - Charged my Insurance $737.75
Said they needed a follow up and Ultrasound - Charged insurance $1419.75
Found nothing wrong. Bad film reader evidently.
I am responsible for $725.50.
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Mammogram - Diagnostic
Amount: $187.00
Posted by: Seema in Port orange, FL.Posted: October 3rd, 2014 01:10PM
Clinic or Doctor: Port Orange ImagingInsurance Carrier:
Type of Policy: BCBS State PPO
I have never had one before and my Doc Rx me a diagnostic mammogram as I was having breast pain. She never told me that there is a difference between diagnostic and screening. I called the clinic as well as the BCBS website to see if it was covered and didn't see anything to be concerned about until I saw the bill.
This is a rip off...the doc should have mentioned that there is a difference and she told me that she was not aware that my insurance doesn't cover it. That's a rip off as well as she has been in practice for over 20+ years and the clinic never mentioned anything to me either.
I think they are all in it together.
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Diagnostic and Ultrasound
Amount: $0.00
Posted by: jefff in Milwaukee, WI.Posted: May 28th, 2014 07:05PM
Clinic or Doctor: AuroraInsurance Carrier: na
Type of Policy: na
Came here researching costs for a friend. She needs a diagnostic and an ultrasound, and was quoted, I kid you not...$7000. This is her new deductible, so it's out of pocket.I'm going to find some one to discuss this with....
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Complete Ripoff
Amount: $521.00
Posted by: IvyArlene in Plano, TX.Posted: April 22nd, 2014 11:04AM
Clinic or Doctor: Solis Women\\\'s HealthInsurance Carrier: Aetna
Type of Policy: PPO
There was an area of concern on my mammogram from last year, so they did an out of pocket was 161 dollars. But on the six month follow up, just a mammogram and one minute of a doctor's time to confirm that NOTHING CHANGED cost me $360 dollars out of pocket. I too feel they should tell women up front what their "diagnostic" fees are. It feels like a complete shake-down and I don't think I'll be getting any more "diagnostics". Hey, it's April of 2014 - time to add some years to your Year drop-down box!
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Preventive Vs. Diagnostic
Amount: $0.00
Posted by: a user in Brookville, IN.Posted: October 23rd, 2013 10:10PM
I too agree it makes no sense to submit a claim for a mammogram as diagnostic unless they are doing something non standard protocol or performing a procedure. If it were a colonoscopy and a polyp needed to be removed, it would make sense for the provider to submit a claim as diagnostic. Mammograms, x-rays, MRI's, CTScans, ect are expensive. You're not just paying for the expensive equipment they use but also for the staffs wages, building (all overhead costs), and costs transferred to you for those who couldn't afford to pay their bills or didn't pay. Healthcare is not cheap and insurance comes at a high price because of it.
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Charge $537, Insurance paid $147
Amount: $0.00
Posted by: Cycledoc in Bellingham, WA.Posted: September 22nd, 2013 10:09AM
Clinic or Doctor: Mt Baker Imaging, Bellingham, WAInsurance Carrier: Group Health Cooperative
Type of Policy: Medicare Advantage
I guess a walkin without coverage would be billed over $500 for a screening mammogram.
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Free Mammograms
Amount: $0.00
Posted by: Happy with Utah Cancer Program in Salt Lake City, UT.Posted: July 24th, 2013 04:07PM
Clinic or Doctor: Utah Cancer ProgramInsurance Carrier: None
Type of Policy: None
I just wanted to reply to the Women who said they have no insurance. Here is Utah we have the Utah Cancer Program. Women 40 or over can have a free screening mammogram. This is what I do. Well, after my last mammogram of over a weed ago, I got called and told that I will need to see the radiologist for a diagnostic mammogram.

Well that set alarms going off for me being without insurance, and I the told the Lady on the phone, that I did not have insurance, so I would have to plan first, to come up with the money, and She said we take of that. So my diagnostic mammogram is free, also.

I just wanted to bring this up, because those of you who do not have insurance, might want to look into your state programs, to learn if your state has a Cancer program.
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Diatgnostic versus routine mammograms = $$$$
Amount: $276.00
Posted by: Catching on in Idaho in Idaho Falls, ID.Posted: May 22nd, 2013 01:05PM
Clinic or Doctor: Eastern Idaho Reg. Medical Ctr. ImagingInsurance Carrier: Meritain
Type of Policy: Employee Group
Wow! I went in for a normal routine mammogram. They said they saw something and wanted to look closer. I agreed, but did not ask what it would do to my insurance claim... Big mistake...HUGE! Apparently "routine" is 100% covered, but "Diagnostic" is not. Tricky wording. I have learned to ALWAYS ask the medical professionals who are helping me what the costs for that procedure are. They may look irritated and bothered, but I ask them to check anyway. If they already don't know, they should! It's like shopping for groceries... prices are relevant.
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Mammograms and Ultrasound
Amount: $0.00
Posted by: Happy with HMO in Gaithersburg, MD.Posted: March 3rd, 2013 05:03AM
Clinic or Doctor: Insurance Carrier: Kaiser
Type of Policy: HMO
Four months ago I had my annual screening mammogram. It showed an area that needed further study. I had a diagnostic mammogram followed by ultrasound. The area appears to be benign but I am scheduled for a six month follow-up mammogram and ultrasound. My doctors, nurses and technicians have been supportive all the way. Everything has been well explained to me and I have incurred no out of pocket expenses. I love my HMO.
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I dont know what to do.
Amount: $0.00
Posted by: Broke Brook in Chapel Hill, NC.Posted: February 21st, 2013 01:02PM
Clinic or Doctor: Insurance Carrier: BCBS
My annual was no charge but they want a diagnostic view. I know this is out of pocket because I have a high deductable. Im trying to find a free clinic or discount but cant seem to get answers. Apparently this is only available if you are on medicaid. Why not keep us taxpayers alive? Sadly I will take my chances and pay my car insurance, buy gas and a few groceries. GRRRRR
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WIsh I had known mine was "diganostic" before I went
Amount: $758.19
Posted by: SW in Ann Arbor, MI.Posted: February 12th, 2013 09:02AM
Clinic or Doctor: University of MichiganInsurance Carrier: Blue Cross/Shield
Type of Policy: PPO
I have been having annual screenings for three years since an initial cyst was found three years ago. I understand that the first would be considered diagnostic but since cysts are my normal I would think that an annual screening would be all that's needed for me unless they found evidence to the contrary. We used to have Blue Care Network HMO and everything was convered including ultrasounds on any suspicious areas (first done during the initial mammogram). Imagine my surprise at opening my mail yesterday and finding this huge bill!rnrnI've contacted the insurance, the hospital billing system, the imaging center, the primary care physician's office - and get varying degrees of "This was diagnostic, not routine, you should have known that, too bad, you have to pay." When it's all been covered in the past, and I had no way of knowing they considered EACH subsequent once-only mammogram diagnostic, and I called BCBS two days before my appointment to ensure it was covered - how was I to know the difference? It's never been pointed out they were all diagnostic and I don't think most patients are aware of the significant differnce that little bit of language gymnastics will have on their pocketbooks. I don't consider myself dumb, but I've been treated this way consistently while questioning this bill that I was totally not expecting and am unprepared to pay.
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Diagnostic Mammos
Amount: $500.00
Posted by: afreire in North Bergen, NJ.Posted: February 4th, 2013 07:02AM
Clinic or Doctor: Hackensack HospInsurance Carrier: Cigna
Type of Policy: PPO
Routine mammos are 100% but forget it if you need diagnostic. I found a lump at 35 yrs old and was diagnostic mammo so it wasnt free. Was getting billed and was required 6 month follow ups and ultrasounds and fine needle done evr6mo. Im about to be 40, still having issues, no cancer thankfully but if I want to get checked, I have to pay. I go to work everyday and pay medical insurance and I am no longer seeking medical attention because the costs are so high and now the hospital wont bill me, they want payment upfront. I now have a huge lump and wont go get checked. i know I sound ignorant by saying that but the costs have been thousands and im still paying insurance. Its just not fair. Mammos whether preventative or diagnostic should be covered at 100%. Its so sad that being a responsible person is like a punishment. I work, pay my bills, have insurance coverage and because i have a lump in my breast i feel like i cannot get the testing done because i will be further in debt.
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Check Before you GO!!!!
Amount: $2,000.00
Posted by: Why? in Carthage, MO.Posted: December 10th, 2012 08:12AM
Clinic or Doctor: Mercy McCune BrooksInsurance Carrier: First Health Network
I was shocked at the bills I got after having a diagnostic mammogram done recently. $778 per breast! Then all sorts of hospital fees, etc. The amount is over $2,000 all deductible, so all out of our pockets. No one ever explained that cost of this type of mammo was so much greater than a screening one...I too feel tricked, having a hard time finding any organizations that can help with payment, since I was blessed to not have any cancer found. I will take health over money, but sure would be great if someone could do something about these insane costs.
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Cancellation of an appt for mammogram
Amount: $100.00
Posted by: Melissa L Garman in Ephrata, PA.Posted: December 7th, 2012 08:12AM
Clinic or Doctor: Ephrata Community HospitalInsurance Carrier: HealthAmerica ONE
I had to cancel the appt and we also looking into canceling our insurance policy. We have an outstanding bill for $3000. due to a kidney stone ( 2 yrs ago and a mental health issue (ME). Money issues brings out the demon of my feelings and I don't want any more expenses to pay on.
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Mammogram and Ultrasound!!!
Amount: $1,600.00
Posted by: Marifrances Justus in Dublin, OH.Posted: December 3rd, 2012 09:12AM
Clinic or Doctor: Ohio HealthInsurance Carrier: Blue Cross Blue Sheild
2010, 46 yrs., Had found a lump I had lumps before so I wasn't to scared. I am blessed, thank you God! I called told them I found a lump they got me right in. was charged a minimal fee. 2012 Mammogram, Ultras Sound at the same place. 48yrs old now found 6 plus lumps, this time I did the same thing called did not need a referral got right in, received a bill for $1,600 plus, because I haven't received the charge yet for the radiologist. when I called the billing department she told me it was because I said I found a lump, so next time I wont call it a lie but omit information, you can learn a lot from your kids.... rnI will be disputing this, why do you think our insurance is out of control, realistically its the medical... that screw us and the insurance companies with these big claims. if we don't dispute these fees its our fault for not standing up. I feel like I am being punished because I found some thing. rnI am married and have 5 children 1 income, who can afford to work and pay for child care now days. you cant say well why did you have so many kids, you cant predict the future who new our country would be where it is today.
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Diagnostic Mammogram
Amount: $750.00
Posted by: Suspicious of the diagnostic need! $$$$$ in Baltimore, MD.Posted: October 18th, 2012 11:10AM
Clinic or Doctor: Mercy Medical Center, Baltimore, MDInsurance Carrier: BC/BS
I have a family history and a biopsy 5 plus years ago showed benign but questionable cells. I think questionable so that I continue to get diagnostic mammograms. My insurance has changed over the years,but I wanted to stay with the same service. I just got billed for a mammogram over a year ago. The whopping bill was $750.00. So now I am due again, and I am not going to do it. It is a racket. Even though the test saved my Mother twice, I feel that they have women living in fear and just charge whatever they want. Our health care is just wrong.
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Diagnostic Mammogram
Amount: $130.00
Posted by: E.D. in Douglasville, GA.Posted: October 16th, 2012 08:10AM
Clinic or Doctor: Douglas HospitalInsurance Carrier: Coventry of GA
Type of Policy: PPO
After having my first screening mammogram, the radiologist wanted more films. Apparently this is common with a first mammogram since they have no history. Unfortunately, this is considered a diagnostic mammogram and is therefore no longer considered preventative by insurance. Since I new this would now be subject to my $3000 deductable, I asked about the costs. I was told that the fee could be upwards of $400 and that most insurance pays around $200 but they also offer a discounted self pay program which costs $130. When registering for my appointment I was told that through my insurance I would have to pay $176.09 (which would be applied to my deductable). I opted to just do the self pay program and paid only $130. (Note, if an ultrasound would have also been required, that would be another $130). When you do the self pay program, they make you sign something saying that you will not turn it in to your insurance.
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Screening Mammogram
Amount: $0.00
Posted by: E.D. in Douglasville, GA.Posted: October 16th, 2012 08:10AM
Clinic or Doctor: Douglas HospitalInsurance Carrier: Coventry of GA
Type of Policy: PPO
DOUGLAS HOSPITAL Amount Billed $599
G0202, U403 $533 Paid: $183.83 Rej: $349.17 exceeds contract
77052, U403 $66 Rej: incidental to service

G0202 $149 Paid: $73.31 Rej: $75.69 exceeds contract
77052 $15 Rej: incidental

Entire Bill $763, Contracted amount with insurance $257.14, My cost $0

I'm sure if you don't have insurance you could negotiate a price similar to what they accept from the insurance.
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Diagnotic Mammogram & Ultrasound
Amount: $600.00
Posted by: Concerned Citizen in Kansas City, MO.Posted: September 16th, 2012 07:09PM
Clinic or Doctor: Insurance Carrier: Cigna/Aetna
Type of Policy: Cigna/Aetna
First of all, I would like to state that I am blessed that I do not have cancer and that my husband has a job. My complaint is as follows: In 2011 when I found the lump in my breast my insurance carrier was Aetna Insurance. My doctor ordered a mammogram & ultrasound. Of course, it was not covered as it was considered diagnostic. The original amount was applied to my deductible. rnMy husband's employer changed insurance carriers to Cigna and again my mammogram & ultrasound amount was considered diagnostic. The insurance company paid nothing as my deductible is $1500.00 per person. Since they have found an area of concern they want to monitor every 6 months. I owe the breast center approximately $800.00 of which I cannot afford to pay no job and living on one income. This whole healthcare thing is a rip off. The health insurance companies spend millions on political campaigns but cannot pay a claim. Wait until the healthcare bill gets a rolling. Many people are going to be surprised.
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Expensive Diagnostic Mammo and Biopsy
Amount: $3,009.00
Posted by: Emily in SF Bay Area in San Francisco, CA.Posted: September 13th, 2012 04:09PM
Clinic or Doctor: CMPC California Campus Breast CenterInsurance Carrier: UnitedHealthCare
Type of Policy: Choice PPO
Just want to show you guys the expensive costs of breast health care in SF bay area in CA. rnrnI am 41 yrs old and this was my first mammogram. I went in on 8/2 for screening. But they found something and asked me to come again for additional images. So I went again on 8/10 for diagnostic mammogram on both breasts and then the technician said they needed ultra sound. After that, the nurse told me that they need biopsy on both breasts so I went there again on 8/16. rnSo the costs for all these medical services:rn8/2 billed as Lab Service $49rn8/10 Additional images $49rn Diagnositic mammogram $403rn Ultra sound $755rn Fees to radiologist $149rn TOTAL = $1,356rn8/16 all billed as Lab Services $407 + $300 + $897 = $1,604rnrnAfter UHC applied some plan discounts and the amount of my PPO plan paid, I have to pay $281.23 out of my pocket. I feel lucky to have insurance from my husband, since I am currently unemployed... I just could not imagine how women without proper insurance to get preventive care... Look at how expensive for the diagnostic mammo and ultra sound? it only took about 10 mins for taking the ultra sound!
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United Health Care Insurance doesn\'t cover routine mammograms
Amount: $0.00
Posted by: forget-me-not in Boulder, CO.Posted: June 22nd, 2012 06:06AM
Clinic or Doctor: Insurance Carrier: Golden Rule
Type of Policy: UHC One
The comment made after I published my experience with UHC was made by them. It looks like they cannot profit from informed people, but its good to know who they realy are. Mammogram benefits along with their other covered benefits might turn to be a baloon.
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Cost of a Mammogram May 2012
Amount: $564.71
Posted by: In Debt in Hattiesburg, MS.Posted: May 30th, 2012 10:05AM
Clinic or Doctor: Wesley HospitalInsurance Carrier: none
Type of Policy: none
So far I have been billed $564.71 for a mammogram, performed at Wesley Hospital in Hattiesburg, Mississippi during May 2012. $439.71 from the hospital and $125 from the radiologist. If you add the gyn doctor's yearly visit (150.00), the total comes to $714.71.
Where is the love? Grateful to be healthy. At this rate who can pay for medical care?
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Cost of Mammogram in Burlington VT
Amount: $598.77
Posted by: BarbaraVermont in Burlington, VT.Posted: May 15th, 2012 01:05PM
Clinic or Doctor: FletcherAllenInsurance Carrier: BCBS
Type of Policy: PPO
Total cost was $598.77 for hospital and physicians fee. My share was 119.75. I am going to check other centers, this is ridiculous for the ins carrier and me to pay this kind of money. Articles on internet state average costs about $250, Where?
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Cost of Mammogram
Amount: $0.00
Posted by: concerned in north, MS.Posted: May 10th, 2012 12:05PM
I found a lump and my doc says I need a Diagnostic....I currently don't have insurance. She says "she doesn't like the feel of the edges". But looking at these posts I'm concerned that I won't be able to pay to have it done. Maybe I shouldn't have it done.
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UHC Golden Rule
Amount: $0.00
Posted by: DC customer in Washington, DC.Posted: March 21st, 2012 08:03AM
Clinic or Doctor: GT University HospitalInsurance Carrier: Golden Rule UHC
Type of Policy: Choice Plus
This is just to comment on the post from a user in Boulder, CO. I live in Washington, DC and UHC Golden Rule clearly confirmed to me that annual AND diagnostic mammograms and breast ultrasounds are covered, no deductible applies (and they paid all my annual screenings and diagnostics for breast mammogram). Not sure why in CO they have a different coverage, probably, it's due to different consumer regulations in your state, or you may had used a non-network provider. However, if you go to any EU country, the cost of mammogram can not be less than EUR 150, which is still much more than $90 repriced amount of the Golden Rule network providers. I lived in Germany for a long time, and know their prices quite well. Therefore, the $90 negotiated network provider cost for mammogram from Golden Rule is a great deal, by any standards.
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Mammogram Rip Off in Kirkland, WA
Amount: $740.00
Posted by: Disgusted patient in seattle, WA.Posted: March 8th, 2012 02:03PM
Clinic or Doctor: Evergreen Hospital, Kirkland, WAInsurance Carrier: None
It was shocking to see two bills totaled $740.00 for a diagnostic mammogrạm. I wonder if there might be a conspiracy to rip patients off? I do not like Evergreen Hospital anymore, they are way too expensive!

Buyers beware of this
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UHC Mammogram - Not a Covered Benefit, as stated in their policy
Amount: $95.00
Posted by: a user UHC in Boulder, CO.Posted: March 7th, 2012 06:03PM
Clinic or Doctor: Boulder, ColoradoInsurance Carrier: Golden Rule
Type of Policy: UHC One
After I went for my routine annual mammogram, which was supposed to be covered by my insurance,as stated under the section 8:covered benefits of my policy, I got a bill. From the isurace I was told that it was reported as a doctors visit,a disease problem etc. rnAs I specifically requested, before I schedule my appointment that I would like to have my annual breast exam, the doctors office reported it as a disease problem. And when I called the doctors office, the medical assisstant told me they reported it as usual. The medical assistant promissed she will call my insurance to confirm it was annual breast exam so I could have it covered. From the insurance: she's been told that I was charged because I didnt meet my deductable, and the previous year I had it covered because I had met my deductable. (This is not true because I went to a doctor only once in 2010 - for the mammogram, and I had it covered). In the policy its is stated that I can have one routine or diagnostic mammogram per calendar year as a covered benefit and does not go against the deductible.rnIn 2012, in the difficult times, it isn't. (Why am I surprised? My fault). rnI went to Europe and had everithing done perfect for about 30 dollars, no problems, no unexpected bills. rnI didnt have the mammogram done in Boulder Community Hospital(a hospital from the UHC network), when I found out that I will be charged for the doctors visit, as I suspected they won't cover it. And I was right. I ended up paying only the repriced amount of $95 for the doctors visit. So I had the job done in EU. :)))
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Preventive Mammogramm
Amount: $0.00
Posted by: Happy Patient in Washington DC, DC.Posted: February 22nd, 2012 07:02AM
Clinic or Doctor: Georgetown University HospitalInsurance Carrier: Golden Rule UHC Choice Plus
Type of Policy: dont know
I had 2 mammograms done, one preventive, another diagnostic, because the first one showed a shadow and they needed to take another look (which turned out to be nothing). The network provider negotiated cost was around $100 per each procedure, which I would have no problem paying, but Golden Rule has a new policy that BOTH preventive and diagnostic mammos are covered no deductible, so I ended up paying zero. Very happy so far with my insurance. They also pay for breast ultrasound with no deductible.
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New insurance laws affect costs to patient
Amount: $0.00
Posted by: BreastImager in Ann arbor, MI.Posted: February 16th, 2012 06:02PM
Type of Policy: Bcbs
Much of the info posted on this site is based on an individuals view of the system--from the outside. These billing issues are very complicated and constantly changing.
Bottom line: if you tell your doctor or technologist that you have a breast complaint, if you are recent breast cancer patient or you had previous abnormal mammo recommending follow up, then you are DIAGNOSTIC and copays and deductibles apply. If you are asymptomatic and have no recent surgery or abnormality on mammo then you can be a SCREENING which under obamacare is a covered preventative service. The imaging center and the radiologist get paid nearly the same for each type of exam regardless. Unfortunately, due to this artificially created distinction between exam types, the patient feels a huge difference as the preventive exam is "free" to you. If everyone voiced their opinion to their politicians we could maybe get this changed. This is going to get worse with the new government task force recommendations.
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