Paying cash for a mammogram: How do you find out the price?

Filed Under: Costs, Patients, Providers

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SUMMARY:  We are often asked how to find out prices in health care.  There are some simple suggestions. In this case, we tell how to find the charged price for a mammogram, though the suggestions would work for any procedure. Keep reading for a list of tips, or …

 

 


People ask us all the time how to have a conversation about health-care charges. This question came from the G-mail inbox, and we thought we’d answer here.

“Hi, We live in Kansas City. We have a very high deductible.  We will pay ‘cash’ at a reasonable rate for preventative care.  It’s been 3 years since my wife had a mammogram.  Is there a directory to find physicians/radiologists that we can pay ‘cash’ at a reasonable amount? Does the directory show what they charge for “cash” payers?   Does the directory show the type of equipment used for the test?

We do not have price listings in Kansas City yet, but I can offer a few thoughts:

1. We ask providers: “What is your cash or self-pay rate for a screening mammogram, HCPCS code 77057 ?  That would be the rate if I am paying in advance, cash.”

2. They tend to have a number, and the numbers are all over the map. In NYC alone, we found people charging as little as $50 and as much as $1,100 and even more. Here are the results of our pricing survey in the NYC area, and here is the last in a series of blog posts we wrote about prices in NYC, from a crowdsourcing partnership with our local public radio station. The other posts are catalogued a the bottom of the piece. You will notice that a lot of women paid around $200 cash, and some paid $400.

3. We recommend that you use our search box at the top of our home page to find out what Medicare pays for that procedure in your area. Here’s the link: In Kansas City, the $11 is for a  processing fee that seems to sometimes be charged and sometimes not, and $79 for the actual procedure. Then you could use that info to survey providers yourself.

4. Ask “Does that include a reading fee? Are there any other charges?” It’s a good idea to ask also how the results will be delivered or sent to someone else (your primar doc?) and if there will be a fee for that. There shouldn’t be, but we have heard of providers that do charge a fee.

5. As you are calling, keep notes: names and phone numbers of people you’re talking to.

6. When you settle on a provider, call back, and ask for the price in writing, or ask for a receipt upon payment stating that you are paid in full for this procedure.

7. Always choose accredited providers; in the case of mammograms, the American College of Radiology accredits providers. Here’s a page where you can find providers in your area.

We do not routinely ask what kind of equipment is used, though you could.

Want more details? Here’s another blog post from our crowdsourcing partnership with WNYC about the price of mammograms.

 

 

 

 

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