A screening mammogram costs $0 out of pocket for most women with insurance, thanks to federal preventive care rules. Without insurance, the price typically ranges from $100 to $300 depending on your location, the facility, and whether you get a 2D or 3D scan. The real surprise for many women is what happens if the screening finds something that needs a closer look: diagnostic mammograms and follow-up imaging can cost hundreds or even thousands of dollars.
Screening Mammograms With Insurance
Under the Affordable Care Act, most health insurance plans must cover screening mammograms with no copay, no coinsurance, and no deductible. This applies to women at average risk starting between ages 40 and 50, with screenings covered annually or every two years depending on your plan and your doctor’s recommendation.
Medicare Part B also covers one screening mammogram every 12 months at no cost to you. Medicaid coverage varies by state, but all state Medicaid programs cover mammography for eligible women. If you’re on a grandfathered insurance plan (one that existed before the ACA took effect in 2010 and hasn’t been substantially changed), the zero-cost requirement may not apply, so check with your insurer.
What a Mammogram Costs Without Insurance
If you’re paying entirely out of pocket, expect to spend roughly $100 to $300 for a standard 2D screening mammogram. Prices vary widely by region and facility. Hospitals tend to charge more than independent imaging centers. Some facilities offer cash-pay discounts or sliding-scale fees if you ask.
3D mammograms (also called tomosynthesis) generally cost more than 2D scans. Insurance coverage for 3D mammography varies by state and provider, and even with insurance you may face an out-of-pocket fee for the 3D upgrade. If cost is a concern, ask the scheduling office whether your plan covers 3D specifically or whether you’d owe extra.
Diagnostic Mammograms Cost More
This is where costs catch people off guard. About 10% of women who get a screening mammogram are called back for follow-up imaging to investigate a potential finding. That follow-up is classified as a diagnostic mammogram, and it’s billed differently. The average out-of-pocket cost for a diagnostic mammogram is around $234, according to a Susan G. Komen study. If the follow-up requires a breast MRI, the average jumps to $1,021.
The distinction matters because many insurance plans treat diagnostic imaging like any other medical service, meaning your deductible, copay, or coinsurance kicks in. Women who had additional imaging after an abnormal screening paid an average of about $75 in out-of-pocket costs for the imaging alone, compared to roughly $1 for women who didn’t need follow-up. That gap is significant enough to change behavior: research shows women in plans with higher cost-sharing get fewer follow-up imaging tests after an abnormal mammogram, potentially delaying detection.
One important update: the HRSA Women’s Preventive Services Initiative now recommends that additional imaging needed to complete the screening process (including ultrasound, MRI, or additional mammography views prompted by the initial screening) be covered as part of preventive care. This means many plans are beginning to cover these follow-up tests at no cost, though implementation varies. Call your insurer before your appointment to confirm what’s covered.
Hidden Fees to Watch For
A mammogram bill often arrives as two separate charges: a facility fee for the equipment and space, and a professional fee for the radiologist who reads your images. If your screening is covered at $0, both components should be included. But if you’re paying out of pocket or your plan applies cost-sharing, seeing two line items on your bill is normal and doesn’t mean you were double-charged.
Also confirm that the facility you visit is in your insurance network. An out-of-network mammogram that would otherwise be free can leave you with the full bill. Most insurance companies have an online tool showing covered facilities, or you can call the number on your insurance card.
Free and Low-Cost Options
If you don’t have insurance or your plan doesn’t cover screening, the CDC’s National Breast and Cervical Cancer Early Detection Program provides free or low-cost mammograms. You may qualify if you meet all three criteria: you’re between 40 and 64, your household income is at or below 250% of the federal poverty level, and you lack insurance coverage for screening. Each state runs its own version of the program with slightly different names, so search for your state’s program or call the CDC info line for a referral.
Many hospitals and imaging centers also offer free mammograms during October (Breast Cancer Awareness Month) or through year-round charity care programs. Planned Parenthood locations can often connect you with low-cost screening resources in your area, even if they don’t perform mammograms on-site.
What Affects Your Final Cost
- Insurance type: ACA-compliant plans cover screening at $0. Grandfathered plans, short-term plans, and health-sharing ministries may not.
- Screening vs. diagnostic: Screening is preventive and typically free. Diagnostic imaging triggers standard cost-sharing in many plans.
- 2D vs. 3D: 3D mammography costs more and isn’t universally covered without an additional fee.
- Facility choice: In-network imaging centers are almost always cheaper than out-of-network hospitals.
- Your deductible status: If you need diagnostic follow-up early in the year before meeting your deductible, you’ll likely pay more out of pocket. Medicare Part B requires you to meet the annual deductible for diagnostic mammograms, then covers 80% of the approved amount.
If you’re scheduling a mammogram and cost is a factor, the single most useful step is calling your insurance company first. Ask three questions: Is this facility in network? Is the specific type of mammogram (2D or 3D) covered at no cost? And if follow-up imaging is needed, what will I owe? Getting those answers upfront eliminates most billing surprises.