Diagnostic Mammogram Cost in New Jersey
Dx mammo incl cad bi
$174.21New Jersey physician fee2026 Medicare office rate- ✓Your ZIP's wage-adjusted hospital and surgery centre rates
- ✓Five nearby hospitals by name, with CMS star ratings
- ✓The add-on codes that typically land on the bill
- ✓A word-for-word script for asking for a good-faith estimate
- ✓A private link you can reopen and share
- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
New Jersey Medicare physician rate (2026)
+11.0% vs nationalAverage of 2 localities. Office range $169.74–$178.68.
Your ZIP in New Jersey
Look up your ZIP code to see whether northern or rest-of-state New Jersey pricing applies, from Newark, Jersey City, and Bergen County down to Trenton, Cherry Hill, and the Jersey Shore.
What diagnostic mammogram costs at hospitals near you
Everything above is a national average. The hospital you pick in New Jersey 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.
One-off payment, no account and no subscription. You get a private link and an email. No medical records and no insurance card, ever.
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 centre 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.
National vs New Jersey
Where New Jersey ranks for this CPT
CPT 77066 by New Jersey locality
| Locality | Office |
|---|---|
| northern nj | $178.68 |
| rest of new jersey | $169.74 |
PE GPCI ranges from 1.092 to 1.160 in New Jersey. That index is why the same CPT is not one price statewide.
Diagnostic Mammogram and how New Jersey is priced
New Jersey is split into two payment localities: northern New Jersey, which carries higher adjustments befitting its position in the New York metropolitan orbit, and the rest of the state to the south. Both localities price above the national average, but the northern one ranks among the more expensive in the country. The dividing line means a procedure in Bergen County is approved at a higher amount than the same one in Cherry Hill or along the shore. South Jersey's pricing gravity pulls toward Philadelphia even though its locality is its own.
New Jersey may be the ultimate cross-border care state: North Jersey residents flow into Manhattan hospitals, South Jersey residents into Philadelphia's academic centers, and the state's own large systems compete hard in between. Dense population means most residents have multiple hospitals within a short drive, which is real negotiating leverage for a cash-pay patient. The shore counties see seasonal population surges that strain capacity each summer.
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 New Jersey
Diagnostic Mammogram in other states
Diagnostic Mammogram in New Jersey: questions
The 2026 Medicare physician office rate for CPT 77066 averages $174.21 across 2 New Jersey localities, from $169.74 in REST OF NEW JERSEY to $178.68 in NORTHERN NJ. The hospital physician rate averages $174.21. Enter a ZIP for the exact locality.
Yes. CMS splits New Jersey into 2 payment localities. For this CPT the office physician fee spans $8.94 from the lowest to highest locality. Look up your ZIP code to see whether northern or rest-of-state New Jersey pricing applies, from Newark, Jersey City, and Bergen County down to Trenton, Cherry Hill, and the Jersey Shore.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $35 for the office physician line or $35 for the hospital physician line in New Jersey. Medigap may cover that 20%. This is not the hospital facility fee.
No. $174.21 is the Medicare physician allowed amount for CPT 77066. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. New Jersey ranks #47 of 51 states on this physician line (11% above the national office rate of $156.98).