What a mammogram costs without insurance in 2026, and how to avoid the diagnostic-billing trap
A screening mammogram is free or nearly free for most insured women over 40, but one follow-up image can turn that $0 visit into a diagnostic bill of $200 to $600. The most useful thing you can do before booking is ask, in advance, which billing code the imaging center will use.
This guide is based on official documentation, pricing pages, and published directory estimates; we did not run these checks hands-on.
How this guide was built
Federal rules and the Medicare fee schedule come from primary sources. Self-pay prices come from published directories and hospital price-posting data, and each one is labeled an estimate rather than a quote. Two gaps remain. We could not retrieve a FAIR Health procedure-level median for CPT 77067 or 77066, because its procedure search loads as a JavaScript tool, so we have not cited a FAIR Health figure. We also did not review a specific facility’s machine-readable price file, which is where a real cash price would be published.
Sources consulted:
- USPSTF: 2024 final recommendation, screening intervals, and grades.
- Medicare.gov: screening and diagnostic coverage and cost sharing.
- HealthCare.gov: ACA women’s preventive services list.
- DOL/HHS/Treasury ACA FAQ Part 68: federal position on CPT 77067 versus 77066.
- Localis, CMS RVU26D: 2026 Medicare national allowed amounts for 77067 and 77066.
- CoveredUSA, CareRoute, FairVisitHealth, CostKits, and BetterCare: self-pay directory ranges and posted-price data.
What a mammogram costs without insurance in 2026
Self-pay prices vary by facility type, region, and whether the exam is screening or diagnostic. The ranges below are directory estimates.
| Type of mammogram | Self-pay estimate (2026) | Source |
|---|---|---|
| Screening 2D (CPT 77067) | About $100 to $250 | CoveredUSA, CareRoute |
| Screening 3D tomosynthesis | About $150 to $400 | CareRoute, CoveredUSA |
| Diagnostic, bilateral (CPT 77066) | About $200 to $600 | CoveredUSA, BetterCare |
| Posted hospital cash price, screening (CPT 77067) | Median $222; middle half $99 to $312 | FairVisitHealth |
| Posted hospital cash price, diagnostic (CPT 77066) | Median $268 for both breasts; $207 for one breast | FairVisitHealth |
The posted-price medians are the most concrete figures in the table. They come from hospital price-transparency disclosures, not from directory marketing copy. A freestanding imaging center is often cheaper than a hospital outpatient department for the same exam, and directory sources consistently say so.
Medicare sets a much lower reference point. The 2026 national allowed amount for screening code 77067 is $126.26 before locality adjustment, with locality amounts from about $111 to $172 (Localis, CMS RVU26D). The 2026 national allowed amount for diagnostic code 77066 is about $157 (Localis, cited by CoveredUSA).
Why screening is $0 for insured patients (and when it isn’t)
Under the ACA, most plans must cover a screening mammogram every one to two years for women 40 and older with no cost sharing, when the service is delivered by an in-network provider. HealthCare.gov says the mandate covers the service, but adds that “$0 cost isn’t guaranteed in all cases.” Out-of-network imaging, a separately billed facility fee, or a code the plan does not classify as preventive can each bring back a bill.
The federal line is sharper than most patients expect. The DOL/HHS/Treasury ACA FAQ Part 68, issued October 21, 2024, says CPT 77067 (screening, bilateral) should be covered without cost sharing, while CPT 77066 (diagnostic) is generally not treated as a preventive service. The same FAQ gives an example of a 39-year-old whose 77067 claim may carry cost sharing, because the preventive requirement follows the recommended age and interval.
Medicare works differently but reaches the same practical point. Medicare.gov covers a screening mammogram every 12 months for women 40 and older at $0 when the provider accepts assignment. A diagnostic mammogram is covered at 20% of the Medicare-approved amount after the Part B deductible. The amount you owe also depends on other insurance, what the doctor charges, and the type of facility.
The callback trap: how a free screening turns into a diagnostic bill
If the radiologist wants a closer look, the facility may take extra views or order an ultrasound. The visit is then billed as diagnostic (77066) rather than screening (77067). Federal guidance treats 77067 as preventive and 77066 as generally not preventive, so the $0 protection can disappear even though the exam happened as part of the same appointment.
Here is how it plays out. You book a screening, and the claim is coded 77067. The radiologist calls you back for additional images. Those images are billed as a diagnostic service, and your cost sharing applies. Nothing about your health changed between the two steps. What changed is the code on the claim. CostKits makes the same point from the consumer side.
The cost difference is material. For a Medicare beneficiary, 20% of the approximately $157 diagnostic allowed amount is about $31, after the Part B deductible is met. For an uninsured patient paying cash, the same diagnostic exam is typically $200 to $600 or more. The pre-booking questions below are the cheapest protection against that gap.
Ask these five questions when you book, and request written answers where possible:
- “Will this be billed as a screening mammogram, CPT 77067?”
- “If the radiologist calls me back, what will the diagnostic follow-up cost here, and will it be billed as CPT 77066?”
- “What is your written self-pay price for a diagnostic mammogram?”
- “Is the 3D tomosynthesis add-on billed as a separate line item? What does it cost?”
- “Are you in network for my plan, and is the reading radiologist in network too?”
Under 40 or dense breasts? What the guidelines mean for your wallet
Coverage rules change outside the standard window. The DOL FAQ example above shows that plans may impose cost sharing on a screening that falls outside the recommended age range.
The USPSTF, in its final recommendation of April 30, 2024, recommends biennial screening mammography for women aged 40 to 74 with a Grade B. Grade B is the rating that triggers the ACA no-cost-sharing requirement. For women 75 and older, USPSTF gives a Grade I, meaning the evidence is insufficient to assess the balance of benefits and harms, so no federal mandate requires a $0 screening.
For dense breasts, USPSTF gives supplemental ultrasound or MRI a Grade I as well. That means the add-on is not a mandated no-cost preventive service. If you and your clinician decide to pursue it, plan for it to be billed as its own service with its own cost sharing.
For women aged 35 to 39, Medicare.gov covers one baseline mammogram at $0. It is worth knowing if you are approaching Medicare eligibility.
FAQ
The three questions below cover the self-pay price, whether 3D imaging is covered at $0, and what a callback costs. Each answer is a cost answer, and each figure is an estimate.
How much is a mammogram without insurance?
Directory estimates put a 2D screening at about $100 to $250 and a 3D screening at about $150 to $400 (CoveredUSA, CareRoute). Diagnostic exams run about $200 to $600 (BetterCare). These are not quotes. Ask each facility for its written self-pay price before booking.
Is a 3D mammogram covered at $0 under the ACA?
It depends on how the facility bills it. FairVisitHealth reports that 3D tomosynthesis is a separate add-on code (CPT 77063), with a median posted hospital cash price of $55. The preventive protection in the DOL FAQ attaches to the screening code, so ask whether the add-on is billed as its own line. HealthCare.gov notes that $0 cost is not guaranteed in all cases.
What if I’m called back after a free screening?
A callback usually means the visit is re-coded from screening (77067) to diagnostic (77066), and the $0 preventive protection generally does not carry over. For Medicare, the cost is 20% of the allowed amount after the Part B deductible, roughly $31 on a $157 allowed amount (Medicare.gov, Localis). For an uninsured patient, the cash price for a diagnostic exam can run from $200 to $600 or more. Get the diagnostic self-pay price in writing before the appointment.
The bottom line: book the screening, then ask the questions
If you are insured and in network, a screening mammogram should cost $0 under the ACA or Medicare. If you are uninsured, self-pay screening estimates start around $100. Before you go, confirm the code is 77067, confirm the facility and reading radiologist are in network, and get the diagnostic self-pay price in writing. Skipping the screening to avoid a bill that may never arrive trades a small, manageable cost risk for a larger one.
Verify any Medicare figure in the CMS Physician Fee Schedule Look-Up Tool before relying on it, including the figures in this article.