Latest news:

June 24, 2014:
Co-Pays and out of pocket costs for this procedure can be as high as $345.


Mammography Reimbursement:

Under the Affordable Care Act, also called Obamacare, most plans provide coverage for standard mammograms, but would not necessarily cover the price of 3D mammography.

Does insurance cover 3D mammography (tomosynthesis)?

Still may be considered experimental or novel by many policies

The cost of tomosynthesis coverage is often borne by the patient, and can vary depending on the setting and environment. For example, high-end clinics are likely to charge more, and this not only is meant to cover the cost of the machine, which can run upwards of $500,000 but also the price of the doctors who need the skill to navigate the three dimensional output and let you know if there are any areas of concern. For the patient, who may have had problems in the past due to dense breast tissue or the presence of implants, the price may be worthwhile. For those anxious about breast x-rays and their interpretation, the fact that there are fewer false positives as well as better chances for detecting cancers may be of some consolation. Nonetheless, 3-D mammography is not available everywhere and may currently be found in clinics that serve an upper-income clientele. As technology improves, and mass production reduces the price of equipment, these costs can go down.

At many clinics, the cost of tomosynthesis is only an additional $50, which is more reasonable but may be difficult for some patients. The trend toward more expensive digital imaging devices has picked up steam since the machines were allowed for use in 2011, so now more and more doctors are publicizing their acquisition of three dimensional mammography equipment. The competition for your healthcare dollars, whether they come from Cadillac plans, HSAs, or your own pocket, is still a big part of the medical industry, but the improved quality should be of interest to both the doctor and the patient, given that fewer false positives and false negatives is something that provides peace of mind as well as better potential for early detection.

Notes and Special Information

Special note: When looking for 3-D mammography prices, it may pay to just ask how much the procedure costs without insurance reimbursement. Some doctors may be able to offer pricing on a group rate or sliding scale.