Bone density tests, also called DEXA or DXA scans, are available at hospitals, outpatient imaging centers, and some specialty clinics. Most people get one through a referral from their primary care doctor or gynecologist, though direct-to-consumer options exist as well. The scan itself takes about 10 to 20 minutes and is completely painless.
Types of Facilities That Offer DEXA Scans
The most common places to get a bone density test are hospital radiology departments and freestanding diagnostic imaging centers. Large hospital systems typically list DEXA scans under their imaging or radiology services, and many have multiple locations with both inpatient and outpatient scheduling. If you live near a teaching hospital or medical center, that’s often the easiest route.
Outpatient imaging centers (sometimes called diagnostic imaging or radiology clinics) are another widely available option. These tend to have shorter wait times and a more streamlined check-in process compared to hospital-based scans. Many are located in medical office parks or strip malls, and you can usually find several in any mid-size metro area by searching “DEXA scan near me” or “bone density test” plus your city.
Some endocrinology and rheumatology practices have their own DEXA machines on-site, which means you can get tested at the same visit where your specialist reviews results. OB-GYN offices occasionally offer bone density screening as well, particularly in practices that focus on menopause care.
A newer category is direct-to-consumer DEXA providers. Companies like BodySpec operate in select cities and let you book a scan without a doctor’s order, often for $40 to $60 per session. These scans also provide body composition data (fat and lean mass), which appeals to people tracking fitness goals. However, the clinical bone density report from these providers may not carry the same weight with your doctor as one from an accredited medical facility.
Do You Need a Doctor’s Referral?
For insurance-covered scans, yes. Most insurance plans and Medicare require a physician’s order before they’ll pay for a DEXA scan. Your primary care doctor, gynecologist, endocrinologist, or rheumatologist can all write the referral. If you’re unsure whether you qualify, bring it up at your next appointment and ask your doctor to assess your fracture risk.
If you want a scan without going through your doctor, direct-to-consumer providers and some cash-pay imaging centers will perform one without a referral. You’ll pay out of pocket, but there’s no gatekeeping. Just keep in mind that if the results show a problem, you’ll still need a physician to interpret the findings and recommend treatment.
Who Should Get Tested
The U.S. Preventive Services Task Force recommends bone density screening for all women 65 and older, regardless of other risk factors. Postmenopausal women younger than 65 should be screened if they have one or more risk factors for osteoporosis. Those risk factors include low body weight, a parental history of hip fracture, cigarette smoking, and certain medication use.
For men, the evidence is less clear-cut. The task force hasn’t issued a firm recommendation for or against routine screening in men, so the decision typically comes down to individual risk. Men with low testosterone, long-term steroid use, or a history of fractures are the most likely candidates.
These guidelines apply to adults 40 and older who haven’t already been diagnosed with osteoporosis or had a fragility fracture.
What the Scan Costs
A DEXA scan in the U.S. typically costs between $40 and $300 out of pocket. Direct-to-consumer providers sit at the low end of that range, while hospital-based scans without insurance tend to be pricier. If you have insurance or Medicare and meet the eligibility criteria, your share could be significantly less or nothing at all.
Medicare Part B covers bone density testing once every 24 months for people who meet specific conditions: women determined to be estrogen-deficient and at risk for osteoporosis, anyone whose X-rays suggest bone loss, people taking or planning to take steroid-type drugs, those with primary hyperparathyroidism, or patients being monitored during osteoporosis treatment. More frequent testing is covered when deemed medically necessary. Most private insurers follow similar criteria, though the specifics vary by plan.
How to Prepare for the Test
Preparation is minimal. Stop taking calcium supplements at least 24 hours before your appointment. Wear loose, comfortable clothing without metal zippers, buttons, belts, or buckles. Leave jewelry at home, and empty your pockets of keys, coins, and anything metallic. Some facilities will have you change into a gown, but many let you stay in your own clothes as long as they’re metal-free.
If you take other vitamins or supplements, mention them when you schedule. Your provider will tell you which ones to skip beforehand.
What Happens During the Scan
You lie on a padded table while a scanning arm passes over your body. The machine measures bone mineral density at the hip, spine, or both. There are no injections, no enclosed spaces, and no discomfort. The radiation exposure is extremely low, far less than a standard chest X-ray. Most scans are finished in 10 to 20 minutes.
Understanding Your Results
Results are reported as a T-score, which compares your bone density to the peak bone mass of a healthy 30-year-old. The National Institute of Arthritis and Musculoskeletal and Skin Diseases defines the ranges this way:
- T-score of -1 or higher: healthy bone density
- T-score between -1 and -2.5: osteopenia, a milder form of bone loss that may or may not need treatment
- T-score of -2.5 or lower: likely osteoporosis
Your doctor will use the T-score alongside your age, fracture history, and other risk factors to decide on next steps. A score in the osteopenia range doesn’t automatically mean medication. For many people, weight-bearing exercise, adequate calcium and vitamin D intake, and lifestyle changes are the first line of defense. A score in the osteoporosis range usually prompts a more detailed conversation about treatment options.
Choosing a Quality Facility
Not all DEXA machines and technologists produce equally reliable results. The International Society for Clinical Densitometry (ISCD) runs an accreditation program that evaluates four areas: personnel qualifications, equipment quality control, scan technique, and interpretation standards. Facilities that earn ISCD accreditation have been independently verified to meet current quality standards, and the accreditation lasts five years.
If you’re choosing between facilities, ask whether they hold ISCD accreditation or are accredited by the American College of Radiology. This matters most if your results will guide treatment decisions or if you plan to compare scans over time, since consistent machine calibration and technologist training directly affect accuracy. You can contact the ISCD at [email protected] or 860-259-1029 to ask about a specific facility’s status.
For follow-up scans, try to use the same facility and the same machine each time. Bone density changes slowly, and even small differences in equipment calibration between locations can create the appearance of bone loss or gain that isn’t real.