Mammogram Cost - Buyer Experiences and Price Information

I was referred for a mammogram and ultrasound for a lump that my primary care giver found. Because I am a little over a year too young, my insurance covers nothing.

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.

My mother had breast cancer more than 7 years ago and it was considered sporadic cancer. However, my OB sent me to a breast specialist last year and I go ever 6 months. He wants me to do a Diagnostic Mammogram and I scheduled the appointment for December 18th.
I asked them about out-of-pocket charges but they did not call me back until December 17th to tell me I would have to pay $430 and that doesn't include radiologist charges and other separate charges. This really pisses me off because they want us to do screening each year but then the cost is getting higher which makes it pretty hard to afford.
I know I paid half that price last year.

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.

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.

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.

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.

The provider charged---$ 29,600.00
Insurance paid $148.00
I paid nothing
ARE THEY KIDDING!!!!!!!!! Since when does a mammo cost that much??!!!!!

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....

There was an area of concern on my mammogram from last year, so they did an MRI....my 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!

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.

I guess a walkin without coverage would be billed over $500 for a screening mammogram.

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.

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.

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.

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

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.

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.

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.

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.

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.

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.

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.

DOUGLAS HOSPITAL Amount Billed $599
G0202, U403 $533 Paid: $183.83 Rej: $349.17 exceeds contract
77052, U403 $66 Rej: incidental to service

QUANTUM RADIOLOGY NORTHWEST PC Amount Billed $164
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.

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.

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!

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.

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?

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?

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.