Paying for a mammogram: Medicare, private insurance and free screening programs

What Medicare and most private plans cover for screening and diagnostic mammograms, why the bill can differ, and where to find free or low-cost screening.

Cost should not stop anyone from getting a recommended mammogram, and for most people a routine screening mammogram costs nothing out of pocket. The details depend on whether the exam is a screening mammogram (no symptoms) or a diagnostic mammogram (to check a symptom or follow up a finding), and on your coverage. This guide summarizes the main rules. Plans differ, so always check with your insurer and the facility before your appointment.

Medicare

Medicare Part B covers screening mammograms once every 12 months for women 40 and older, and one baseline mammogram between ages 35 and 39 (42 CFR 410.34). According to Medicare.gov, you pay nothing for a screening mammogram if the provider accepts assignment. Diagnostic mammograms are covered when medically necessary, but the Part B deductible and 20 percent coinsurance generally apply. If you have a Medicare Advantage plan, coverage is at least as broad, but network rules apply; check that the facility is in network.

Private insurance and Marketplace plans

Under the Affordable Care Act, most private health plans must cover preventive services recommended by the U.S. Preventive Services Task Force (USPSTF) with an A or B grade without charging a copay, coinsurance or deductible when you use an in-network provider (see HealthCare.gov). The USPSTF's April 2024 final recommendation is biennial screening mammography for women aged 40 to 74 (grade B). Many plans cover annual screening too; check yours. Some older "grandfathered" plans and short-term plans are not subject to these rules.

Why you might still get a bill

• The exam was diagnostic. If you reported a symptom, such as a lump, or were called back after a screening, the exam is usually billed as diagnostic, and normal cost sharing applies. Ask your plan in advance what you will owe.
• Out-of-network providers. Preventive coverage without cost sharing generally applies in network. Check both the facility and, if billed separately, the radiology group that reads the images.
• Additional imaging. Supplemental imaging such as breast ultrasound or MRI, for example for dense breasts, may have cost sharing depending on your plan and state law.
• 3D mammography. Coverage for digital breast tomosynthesis varies by plan; ask before you book whether there is an extra charge.

If you don't have insurance

• The National Breast and Cervical Cancer Early Detection Program, funded by the CDC and run through every state, DC, several U.S. territories and many tribal organizations, provides free or low-cost mammograms to people with low incomes who are uninsured or underinsured. Contact your state or local health department to find the program near you.
• Community health centers offer care on a sliding fee scale based on income and can refer you for a mammogram.
• Hospital financial assistance. Nonprofit hospitals must have written financial assistance policies. Ask the hospital's billing office before your exam.
• Self-pay prices. Many imaging centers publish a cash price for a screening mammogram. Ask for the total, including the radiologist's reading fee.
• Mobile screening events run by hospitals and community groups sometimes offer screening at low or no cost.

Health savings and flexible spending accounts

If you have a health savings account (HSA) or flexible spending account (FSA), you can generally use it to pay for mammograms and follow-up breast imaging that your plan does not fully cover, because they are medical care. Ask the facility for an itemized receipt, and check your plan's rules or ask your account administrator if you are unsure whether a particular service qualifies.

Questions to ask when you book

• Is this appointment a screening or a diagnostic mammogram, and how will it be billed?
• Are both the facility and the radiologists who read the images in network with my plan?
• Is 3D mammography standard here, and is there an extra charge?
• If I need more imaging, can it be done the same day, and what will that cost?
• Do you need my prior mammograms, and can you request them for me?

Follow-up imaging costs

If a screening mammogram finds something that needs a closer look, you may be asked to return for diagnostic views, an ultrasound or, less often, an MRI or biopsy. Federal preventive-care rules focus on the screening exam itself, so follow-up imaging has often been billed with normal cost sharing, although some states and plans now limit or waive cost sharing for follow-up breast imaging. Before a follow-up appointment, call your insurer and ask what you will owe, and ask the facility for a price estimate. If cost is a barrier, tell the facility: many have financial counselors, and the CDC-funded program above also covers diagnostic follow-up for eligible patients.

Keep the explanation of benefits your insurer sends after each visit. If a screening mammogram you expected to be free shows a charge, call your insurer to ask whether it was coded as diagnostic and whether it should be reprocessed as preventive.

Cost and quality

Every facility on this site holds an FDA certificate under the Mammography Quality Standards Act, which means it meets the same federal standards for equipment, staff and reporting whatever it charges. Choosing a lower-cost certified facility does not mean accepting a lower federal standard. Where a facility matches a Medicare-certified hospital, its profile also shows the hospital's screening recall rate from Medicare data.

Coverage rules change. Confirm current details with Medicare, your insurer or your state's health department. This guide is general information, not medical, insurance or legal advice; talk with your healthcare provider about when you should be screened.

Updated 2026-10-16.

General information only, current as of the date above. The information on Mammography Index is not medical advice and does not replace a doctor, nurse, discharge planner or other qualified professional. Do not use it to make decisions about diagnosis or treatment. If you have a medical emergency, call 911. Rules and programs change; check the official sources linked in this guide.