The cost of a three-dimensional (3D) mammogram, also known as digital breast tomosynthesis (DBT), is highly variable. A 3D mammogram is an advanced X-ray technique that captures multiple images from different angles, creating a layered, three-dimensional view of the breast tissue. This technology is often used for routine screening, but the final price can change dramatically based on the facility, location, and insurance coverage.
Average Sticker Price for 3D Mammography
The “sticker price” for a 3D mammogram—the amount billed before any insurance adjustments—typically falls into a broad range nationally. This list price is set by the provider, but few patients actually pay it. A patient without insurance or receiving the service outside of a discounted network might see an initial charge anywhere from approximately $350 to over $1,500.
This billed amount covers technical fees, such as the use of specialized tomosynthesis equipment and the technologist’s time, and the professional fee for the radiologist’s interpretation of the images. The wide variation is due to a lack of standardization in healthcare pricing, meaning a procedure at one facility can cost significantly more than the exact same service elsewhere. This price range is important to know, but it should not be mistaken for the final out-of-pocket expense.
Understanding the difference between a screening and a diagnostic procedure is important, as this affects the base price. A screening mammogram is a routine check for patients with no symptoms. A diagnostic mammogram is performed to investigate a specific symptom, like a lump, or to follow up on an abnormal screening result. Diagnostic procedures require additional imaging views and a more involved interpretation, meaning they are generally billed at a higher rate than routine screening.
Variables That Change the Total Cost
The sticker price for a 3D mammogram fluctuates widely based on factors related to the provider and the circumstances of the exam. The type of facility where the procedure is performed is a major determinant of the overall cost. Hospital outpatient centers, which often have higher overhead costs, typically charge the most for a tomosynthesis procedure.
Conversely, dedicated breast imaging centers or private, independent radiology clinics often have lower operating expenses, translating into lower billed prices. Geographic location also plays a role in price variation. Facilities located in major metropolitan areas or regions with a high cost of living generally have higher prices compared to those in smaller towns or rural areas.
The procedure type dictates the complexity of the billing. A routine 3D screening mammogram is a preventive service performed on an asymptomatic patient. If the procedure is a 3D diagnostic mammogram, it involves more complex imaging and interpretation, resulting in a higher billable charge. The diagnostic procedure requires the technologist to take additional, targeted images, which increases the time and resources used by the facility.
Insurance Coverage and Calculating Your Out-of-Pocket Expense
For many patients, the final out-of-pocket cost is determined primarily by their insurance plan and whether the exam is classified as screening or diagnostic. The Affordable Care Act (ACA) mandates that most private health plans must cover preventive screening services, including mammography for women over 40, without any cost-sharing. This means no copay, coinsurance, or deductible, and often applies to the 3D portion of the screening, though coverage can vary by state and individual plan.
If the procedure is coded as diagnostic, the financial rules change completely. Diagnostic mammograms are not considered preventive care, and the cost is subject to the patient’s deductible, copayments, and coinsurance responsibilities. This shift can happen even if you went in for a routine check, such as if the radiologist needs immediate follow-up images due to a finding.
The provider’s network status is another factor that impacts your final bill. An in-network provider has a negotiated rate with your insurer, which is significantly lower than the list price. Conversely, an out-of-network provider is not bound by these agreements, and you may be responsible for a much larger portion of the full, non-discounted bill. To get an accurate estimate of your personal expense, you should contact your insurer with the specific Current Procedural Terminology (CPT) codes provided by the imaging center. For a screening 3D mammogram, common CPT codes include 77067 (for the 2D portion) and 77063 (for the 3D tomosynthesis portion), which can help the insurer provide a precise coverage estimate.
Finding Lower-Cost Screening Options
Patients without insurance or those facing high deductibles can seek options to lower their cost. One effective strategy is to price shop by calling multiple imaging centers, especially independent clinics rather than hospital-affiliated facilities. Many centers offer a reduced self-pay rate for patients paying in full at the time of service, which can be much lower than the rate billed to an insurance company.
You can ask for the bundled cash price for a 3D screening mammogram, as this is often a fixed, transparent cost. Several organizations and government programs exist to provide financial assistance for breast health screenings. Local or state-funded breast health programs and specific cancer foundations may offer free or reduced-cost mammograms to eligible individuals, regardless of insurance status.
Hospitals often have charity care policies or financial assistance programs that apply to diagnostic and follow-up procedures for patients who meet certain income requirements. Inquire about these programs before your appointment to understand what support may be available.