Breast cancer is the second most common cancer in women. Therefore, early detection and diagnosis are crucial to getting the best treatment. Mammograms are an essential tool for catching cancer in its early stages, and it is recommended that women over 40 get one every two years.
But how much does a mammogram cost without insurance? The prices of mammograms vary depending on whether they’re screening or diagnostic and if you require an ultrasound. A mammogram can cost up to $500 without insurance coverage.
If you’re a low-income patient going through financial hardship, you might be behind on insurance payments or have no coverage. This article outlines the resources available to get a mammogram without insurance and how much you can expect to pay for one.
How Much Does A Mammogram Cost Without Insurance?
Most private health plans cover the cost of mammograms without a copay. However, you might wonder how much you’d have to pay out of pocket if you don’t have insurance. And how much do different types of mammograms cost? Let’s take a look.
2D Screening Mammogram
A 2D screening mammogram is a traditional type of X-ray of the breast tissue. It produces two-dimensional black-and-white images that help healthcare providers detect lesions, lumps, and other abnormalities. The average cost for 2D screening without insurance is $400.
3D Screening Mammogram
3D mammography, also known as tomosynthesis, is a newer type of mammography that uses 3D technology to take multiple breast pictures at once from different angles. The average cost for a 3D screening mammogram without insurance is $560.
While screening mammograms are usually free for individuals with insurance, diagnostic mammograms usually aren’t covered by insurance. A diagnostic mammogram can cost as low as $199.93 without insurance, but the national average cost is about $499.
What Influences The Cost Of Mammograms?
The prices of mammograms may vary depending on:
- The facility you visit
- The type of equipment used
- Your zip code
- The type of mammogram you need
Also, some facilities may have a sliding scale fee based on income and financial hardship to reduce the cost for low-income patients.
Mostly, patients with insurance have to pay deductibles, copays, and coinsurance costs before their insurance covers any mammogram costs. However, this is different for individuals needing screening and diagnostic imaging in New York.
The New York State breast cancer legislation requires health insurers to eliminate:
- Annual deductibles
- Cost sharing for breast ultrasounds and MRIs, as well as diagnostic mammograms for high-risk individuals
- Co-payments and co-insurance payments for all mammograms
You can get treatment in New York without cost-sharing if you have a non-grandfathered insurance policy under the following circumstances:
- You have a family history of cancers such as breast, tubal, ovarian, or metastatic cancer
- You have to undergo BRCA testing after genetic counseling determines that you’re at high risk
- Your healthcare provider has prescribed medications to reduce breast cancer risk
- You are 40 or older and need a baseline mammogram
How To Get A Mammogram Without Insurance
You can still get a low-cost or free mammogram without insurance or meeting the criteria for coverage. Here’s how to get a mammogram without insurance.
National Cancer Organizations
These are excellent resources for people who need free or low-cost mammograms. They include:
- The Breast Cancer Assistance Program: This program is run by the American Breast Cancer Foundation. It offers free mammograms for those who are uninsured or underinsured.
- The National Breast and Cervical Cancer Early Detection Program: Get free breast cancer screening if you’re a woman aged 40-64 with limited income, without health insurance, or not enrolled in Medicaid from this US Center for Disease Control and Prevention program.
- The American Cancer Society: This is an excellent resource for low-cost mammograms. They offer navigators who can help you find a qualified provider and provide information on how to pay for the screening.
- The National Mammography Program: This program helps you search for low-cost mammography services by zip code.
Healthcare Facilities & Hospitals
Visit your local healthcare facilities and hospitals for low-cost or free mammograms. Most hospitals have a financial assistance department you can contact if you need help meeting the cost of mammograms. Some healthcare centers provide discounted screening mammograms for those with limited means.
October is breast cancer awareness month. During this month, many local organizations offer free or low-cost mammograms. You can search for these programs in your area through the National Breast Cancer Foundation and other organizations.
Where To Get A Free Or Low-Cost Mammogram In NYC
If you’re in NYC, there are many free or low-cost mammogram options. Here are a few of the top providers:
CSP Cancer Screening Services
The Cancer Services Program (CSP) offers cancer screening to eligible patients at select locations. Their services include:
- Breast cancer screening is for women over 40
- Screening for women under 40 with a high risk of developing breast cancer
- Cervical cancer screening for women 40 and older
- Colorectal cancer screening for all men and women with a high risk of developing the disease
For you to qualify for the New York State Cancer Services Program, you ought to:
- Meet age requirements
- Be a resident of New York State
- Not have insurance
- Have an insurance policy with a cost share that’s preventing you from accessing care
- Be within 250% of the federal poverty level
New York City Health + Hospitals
Health + hospitals provide free breast cancer screenings to uninsured individuals with limited income. Their services include:
- Clinical breast exams
These hospitals provide home-based, outpatient, and inpatient care annually for over one million New Yorkers who meet their eligibility criteria. You can find these hospitals in more than 70 locations across all five boroughs.
The New York State Department of Health
The NYS Department of Health offers eligible patients free breast and cervical cancer screenings. They provide mammograms, clinical breast exams, ultrasounds, pap tests, and HPV testing to those who qualify.
They also provide early detection services to women with a provider who has prescribed medications to reduce breast cancer risk. You can find more information about eligibility and services on their website.
If you’re a resident of Harlem, you can access free cancer screenings with Harlem United. Their services are available to individuals of all ages and income levels who have yet to receive a mammogram within the last year.
Harlem United offers imaging and other breast health services, such as genetic counseling and risk assessment for those at high risk of developing breast cancer.
The Brooklyn Hospital Center
The Brooklyn Hospital Center offers low-cost mammograms and other cancer screening services to individuals with limited insurance or no coverage. They provide clinical breast exams, ultrasounds, and mammography screenings for those who qualify.
This hospital works together with CSP to provide much-needed cancer screening services to:
- Women over the age of 40
- Women under the age of 40 with a higher risk of developing breast cancer
Additionally, they provide financial assistance to patients who cannot afford screening services. You can check out the educational resources on their website to understand the importance of early detection and how to access care.
Memorial Sloan Kettering Cancer Center
The Memorial Sloan Kettering offers financial assistance to those with an income below 400 percent of the Federal Poverty Level and who lack sufficient insurance coverage. This helps patients get access to screening services, including mammograms.
This cancer center works with CSP to provide free services to underinsured women aged 50+. That said, for women under 50, you have to contact CSP to determine if they’re eligible for their services.
If you’re diagnosed and need breast cancer treatment, you might meet the criteria for the Medicaid Cancer Treatment Program at Memorial Sloan Kettering. This program helps eligible patients with the financial cost associated with cancer treatment.
Frequently Asked Questions
What is a mammogram?
A mammogram is an X-ray that helps healthcare providers detect abnormalities in the breast tissue. It is a safe and effective way to identify potential tumors before they can be seen or felt during a physical breast exam.
What’s the difference between a screening and a diagnostic mammogram?
A screening mammogram helps look for signs of breast cancer in asymptomatic patients. On the other hand, a diagnostic mammogram is done when a doctor suspects something abnormal may be present, such as a lump or suspicious area found during a physical exam. The images taken during the diagnostic mammogram provide more detailed information about the potential abnormality.
Why are diagnostic mammograms not covered by insurance?
Diagnostic mammograms investigate abnormalities detected in a screening mammogram, such as lumps or other suspicious spots. Therefore, they require specialized techniques to get a more detailed x-ray. Usually, insurance companies don’t cover these types of tests because they consider them experimental.
Can I ask for an ultrasound instead of a mammogram?
An ultrasound is not a substitute for a mammogram. Mammograms are the most recommended screening tests because most breast cancers can only be detected through them.
That said, an ultrasound can help to provide additional information about specific types of breast abnormalities that may be seen on a mammogram.
Ensure you talk with your doctor and discuss which screening tests are right for you.
Don’t let a lack of insurance prevent you from getting a much-needed mammogram. If you’re worried that you might not get a mammogram due to lack of insurance, let Enhance Health help.
We can help you find the best coverage for all needs, including mammogram screening services. Get in touch with us today and we’ll provide you with a list of health plans in your area that cover mammogram screenings.