How Much Does a Diagnostic Mammogram Cost in Montana?
Dx mammo incl cad bi
$156.98Montana physician fee2026 Medicare office rateUnder 2026 Medicare rates, a diagnostic mammogram costs about $157 in Montana at an imaging center or office. In a hospital, the doctor is paid about $46 for the reading and the hospital bills separately for the test.
- ✓Your ZIP's wage-adjusted hospital and surgery center rates
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- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
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- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
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- ✓Printable PDF download
Montana Medicare physician rate (2026)
0.0% vs nationalSingle statewide locality.
Your ZIP in Montana
Look up your ZIP for local context, whether you are in Billings, Missoula, Bozeman, Great Falls, Helena, Kalispell, or one of Montana's frontier counties.
What diagnostic mammogram costs at hospitals near you
Everything above is a national average. The hospital you pick in Montana 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 59001.
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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 Montana the office and hospital physician lines for this CPT differ by $110.56.
National vs Montana
Where Montana ranks for this CPT
Diagnostic Mammogram and how Montana is priced
Montana runs on a single statewide locality with geographic indices near the bottom of the national range, so its published Medicare rates are uniform across nearly 150,000 square miles. Billings and a remote Hi-Line town share identical adjustment factors, a simplicity that belies the enormous distances involved in actually reaching care. CMS applies a rural floor to work adjustments that benefits frontier states like this one. For pricing purposes, Montana is one market; for access purposes, it is dozens of small ones.
Billings hosts the state's largest medical community and serves as a referral hub not just for Montana but for northern Wyoming and the western Dakotas, with Missoula, Great Falls, Bozeman, and Kalispell anchoring their own regions. Frontier counties may be hours from the nearest hospital that performs a given procedure. Some Montanans travel to Salt Lake City, Denver, or Seattle for highly specialized 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 Montana
Diagnostic Mammogram in other states
Diagnostic Mammogram in Montana: questions
Under 2026 Medicare rates, a diagnostic mammogram costs about $157 in Montana at an imaging center or office. In a hospital, the doctor is paid about $46 for the reading and the hospital bills separately for the test. Montana is a single Medicare locality, so the physician rate is the same statewide.
Not on the physician fee schedule. Montana 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 $31 for the office physician line or $9 for the hospital physician line in Montana. Medigap may cover that 20%. This is not the hospital facility fee.
At an imaging center or office, $156.98 is Medicare's full rate in Montana, covering the test and the reading. In a hospital, the physician bills only the reading (about $46.42) and the hospital bills separately for the test. Montana ranks #35 of 51 states on this rate (within 2% of the national office rate of $156.98).