Your Source for Finding Health Care Prices

Cash or self-pay prices and Medicare pay rates. Our metro areas: NYC, SF, LA, Philadelphia, Miami, Tampa-St. Petersburg, Dallas-Fort Worth, Houston, San Antonio, Austin. Others soon!

or within

miles of

For procedure, start typing and let it complete, or use the government pricing system described here. Advanced search page here

Your doctor ordered a second mammogram? Sorry, it’s not covered

Posted by on May 6, 2013


A friend writes:

I need to get a second mammogram and my $743.55 per month Blue Cross insurance will not pay for it.

I have a (single parent/child) Blue Cross/Blue Shield independent Horizon EPO Plus health insurance policy.  I’ve been told that I’ve already reached my maximum for the calendar year of $600 in testing. I live in New Jersey.  The second test is necessary because there was not total visibility on the first one, and the technician would like to try it from a different angle.

So how much does a mammogram cost? Glad you asked.

Trying to get a straight answer to what it will cost to pay for myself, I have been sent into multiple loop-de-loops at the facility where my first mammogram was conducted, which is also where my daughter was born 16 years ago. My employer-sponsored Oxford plan at that time required a mere $100 co-pay for my entire pregnancy and delivery, including two weeks of intensive neonatal care in the hospital for my baby.

I turned to to find a facility to do my second mammogram at a price I can afford to pay. I also want to share my story of how an educated professional who at this time last

year had a six-figure income and 100% company-paid insurance could wind up in this position.

Technically, I needed to get a doctor’s prescription for the second one, but they asked for another angle. So I don’t know that it was a “screwup” or if maybe they saw something they wanted to investigate further and are just staying mum until the second one.

I saw the movie “Sunlight Jr.” recently during the TriBeCa Film Festival. Depicting the story of people living on minimum wage and at the financial edge, it also showcases the impact a lack of health insurance has on day-to-day life choices.

In one scene, the lead character, played by Naomi Watts, goes to a hospital for a sonogram because she is bleeding and thinks she may have miscarried her unplanned baby. In fact, it is a false alarm and she gets to see the beating heart and movements of the fetus for the first time.

This blissful moment is shattered when her partner, a paraplegic alcoholic played by Matt Dillon, rages at her for going for medical care, screaming “You should have called me. I know how these hospitals work. How are we ever going to pay for this? “

After the film and a Q-and-A with the director, my girlfriend expressed surprise that she had not picked up that the point of the movie was to shine a light on the real lives of people who are living this way.

I told my friend I related to the story because I too am living a variation of that nightmare.