How Much Does a Diagnostic Mammogram Cost in Missouri?
Dx mammo incl cad bi
$146.93Missouri physician fee2026 Medicare office rateUnder 2026 Medicare rates, a diagnostic mammogram costs about $147 in Missouri at an imaging center or office, from $140 in Rest of Missouri to $151 in Metropolitan St. Louis. In a hospital, the doctor is paid about $45 for the reading and the hospital bills separately for the test.
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Missouri Medicare physician rate (2026)
-6.4% vs nationalAverage of 3 localities. Office range $140.14–$151.15.
Your ZIP in Missouri
Enter a ZIP code to see which Missouri locality covers you: metro St. Louis, metro Kansas City, or rest-of-state areas like Springfield, Columbia, Joplin, and the Bootheel.
What diagnostic mammogram costs at hospitals near you
Everything above is a national average. The hospital you pick in Missouri 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.
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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 Missouri the office and hospital physician lines for this CPT differ by $101.50.
National vs Missouri
Where Missouri ranks for this CPT
CPT 77066 by Missouri locality
| Locality | Office |
|---|---|
| metropolitan st. louis | $151.15 |
| metropolitan kansas city | $149.51 |
| rest of missouri | $140.14 |
PE GPCI ranges from 0.862 to 0.952 in Missouri. That index is why the same CPT is not one price statewide.
Diagnostic Mammogram and how Missouri is priced
Missouri is a three-locality state: metropolitan St. Louis and metropolitan Kansas City are each priced separately, and everywhere else falls into a rest-of-state locality with lower geographic adjustments. Both metro localities approve higher amounts than outstate Missouri, and the Kansas City locality applies only to the Missouri side of that metro, since the Kansas side prices under Kansas's statewide locality. Springfield, Columbia, and the rural counties all share rest-of-state factors. The metro-versus-outstate gap is the main pricing story here.
St. Louis and Kansas City hold the state's academic medical centers and most of its specialty depth, drawing patients from far beyond Missouri's borders, including southern Illinois and eastern Kansas. Outstate Missouri is served by regional hubs in Springfield, Columbia, and Cape Girardeau, with the Ozarks and Bootheel among the harder places to reach specialty care. Rural hospital viability has been a persistent concern across the state.
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 Missouri
Diagnostic Mammogram in other states
Diagnostic Mammogram in Missouri: questions
Under 2026 Medicare rates, a diagnostic mammogram costs about $147 in Missouri at an imaging center or office, from $140 in Rest of Missouri to $151 in Metropolitan St. Louis. In a hospital, the doctor is paid about $45 for the reading and the hospital bills separately for the test. Enter a ZIP for the exact Missouri locality.
Yes. CMS splits Missouri into 3 payment localities. For this CPT the office physician fee spans $11.01 from the lowest to highest locality. Enter a ZIP code to see which Missouri locality covers you: metro St. Louis, metro Kansas City, or rest-of-state areas like Springfield, Columbia, Joplin, and the Bootheel.
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 Missouri. Medigap may cover that 20%. This is not the hospital facility fee.
At an imaging center or office, $146.93 is Medicare's full rate in Missouri, covering the test and the reading. In a hospital, the physician bills only the reading (about $45.43) and the hospital bills separately for the test. Missouri ranks #15 of 51 states on this rate (6% below the national office rate of $156.98).