How Much Does a Diagnostic Mammogram Cost in Idaho?
Dx mammo incl cad bi
$145.85Idaho physician fee2026 Medicare office rateUnder 2026 Medicare rates, a diagnostic mammogram costs about $146 in Idaho at an imaging center or office. In a hospital, the doctor is paid about $44 for the reading and the hospital bills separately for the test.
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Idaho Medicare physician rate (2026)
-7.1% vs nationalSingle statewide locality.
Your ZIP in Idaho
Check your ZIP code for local context across Idaho, from Boise and the Treasure Valley to Coeur d'Alene, Idaho Falls, Pocatello, Twin Falls, and the remote central mountains.
What diagnostic mammogram costs at hospitals near you
Everything above is a national average. The hospital you pick in Idaho moves the bill more than anything else you control.
Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.
For example 83201.
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What these numbers are
Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery center rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again. In Idaho the office and hospital physician lines for this CPT differ by $101.41.
National vs Idaho
Where Idaho ranks for this CPT
Diagnostic Mammogram and how Idaho is priced
All of Idaho shares a single payment locality, and its geographic indices are among the lowest in the West, so Medicare-approved amounts here undercut those in neighboring Washington and Oregon metro localities. Boise's rapid growth has not changed the statewide pricing structure; the fee schedule treats the Treasure Valley the same as the Panhandle or the eastern farm counties. For patients, that uniformity makes the statewide figures on this site a reliable guide anywhere in Idaho. Cross-border care is where pricing gets more interesting, since adjacent metro localities price higher.
Boise anchors the state's largest medical market, while the Panhandle looks to Spokane, Washington for much of its specialty care and eastern Idaho leans on Idaho Falls, Pocatello, and sometimes Salt Lake City. That means many Idahoans actually receive care priced under another state's locality. Rural and mountain communities face long drives for anything beyond primary care.
This procedure: A diagnostic bilateral mammogram is a focused X-ray examination of both breasts performed because something needs a closer look: a lump, pain, nipple discharge, or an abnormality flagged on a screening mammogram. Unlike screening, a radiologist is typically on site directing extra angled or magnified views in real time, and you often receive results before leaving. Each breast is compressed briefly for each view, and the appointment usually runs 30 to 45 minutes.
What Is Diagnostic Mammogram?
A diagnostic bilateral mammogram is a focused X-ray examination of both breasts performed because something needs a closer look: a lump, pain, nipple discharge, or an abnormality flagged on a screening mammogram. Unlike screening, a radiologist is typically on site directing extra angled or magnified views in real time, and you often receive results before leaving. Each breast is compressed briefly for each view, and the appointment usually runs 30 to 45 minutes.
What Affects the Cost
- –Unlike free screening, diagnostic mammography is subject to deductible and coinsurance on most plans, making the same machines suddenly cost money.
- –Same-day breast ultrasound is frequently added to work up the finding, billed as its own study.
- –3D tomosynthesis views, now common, add a separate code and charge on top of the 2D study.
- –Hospital breast centers bill facility fees that independent breast imaging centers do not.
- –If a biopsy is recommended, that follow-on procedure with pathology is a substantial next cost.
Questions to Ask Before Booking
- 1.Does my state or plan waive cost sharing for diagnostic breast imaging, or will I owe deductible and coinsurance?
- 2.Will ultrasound or 3D views be added today, and what does each cost?
- 3.What is the facility fee at this breast center compared with an independent imaging center?
- 4.If a biopsy is recommended, what would that procedure and pathology cost?
- 5.Can you give me the total for all imaging performed before I leave today?
Other featured procedures in Idaho
Diagnostic Mammogram in other states
Diagnostic Mammogram in Idaho: questions
Under 2026 Medicare rates, a diagnostic mammogram costs about $146 in Idaho at an imaging center or office. In a hospital, the doctor is paid about $44 for the reading and the hospital bills separately for the test. Idaho is a single Medicare locality, so the physician rate is the same statewide.
Not on the physician fee schedule. Idaho uses one locality, so the Medicare physician rate is the same from one end of the state to the other. What still changes is site of service (office vs hospital) and any facility fee the hospital bills on its own claim.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $29 for the office physician line or $9 for the hospital physician line in Idaho. Medigap may cover that 20%. This is not the hospital facility fee.
At an imaging center or office, $145.85 is Medicare's full rate in Idaho, covering the test and the reading. In a hospital, the physician bills only the reading (about $44.44) and the hospital bills separately for the test. Idaho ranks #10 of 51 states on this rate (7% below the national office rate of $156.98).