How Much Does a Screening Mammogram Cost in Pennsylvania?
Scr mammo bi incl cad
$124.55Pennsylvania physician fee2026 Medicare office rateUnder 2026 Medicare rates, a screening mammogram costs about $125 in Pennsylvania at an imaging center or office, from $118 in Rest of Pennsylvania to $131 in Metropolitan Philadelphia. In a hospital, the doctor is paid about $35 for the reading and the hospital bills separately for the test.
- ✓Your ZIP's wage-adjusted hospital and surgery center 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
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- ✓Everything in the Premium report
- ✓15 nearby hospitals instead of five
- ✓Filled good-faith-estimate request letter
- ✓Bill-negotiation letter
- ✓Printable PDF download
Pennsylvania Medicare physician rate (2026)
-1.4% vs nationalAverage of 2 localities. Office range $117.97–$131.12.
Your ZIP in Pennsylvania
Look up your ZIP to see whether metro Philadelphia or rest-of-state pricing applies, from Philadelphia and its collar counties to Pittsburgh, Harrisburg, Allentown, Scranton, Erie, and the rural center.
What screening mammogram costs at hospitals near you
Everything above is a national average. The hospital you pick in Pennsylvania 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 15001.
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 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 Pennsylvania the office and hospital physician lines for this CPT differ by $89.35.
National vs Pennsylvania
Where Pennsylvania ranks for this CPT
CPT 77067 by Pennsylvania locality
| Locality | Office |
|---|---|
| metropolitan philadelphia | $131.12 |
| rest of pennsylvania | $117.97 |
PE GPCI ranges from 0.918 to 1.041 in Pennsylvania. That index is why the same CPT is not one price statewide.
Screening Mammogram and how Pennsylvania is priced
Pennsylvania's fee schedule separates metro Philadelphia from the rest of the state, giving the southeast its own higher-cost locality while Pittsburgh, Harrisburg, Allentown, Erie, and rural Pennsylvania share rest-of-state adjustments. That means the state's second-largest medical market, Pittsburgh, is priced with rural counties rather than with Philadelphia. The Philadelphia locality's premium reflects the metro's wage and rent levels, which lead the state by a wide margin. For patients, the key locality question in Pennsylvania is simply whether care happens in the Philadelphia area.
Philadelphia is one of America's historic centers of academic medicine, dense with teaching hospitals, while Pittsburgh is dominated by a pair of large integrated systems whose rivalry has defined that market for years. The rural middle of the state, sometimes called the T, has far fewer options, and hospital closures there have drawn statewide attention. Residents near the edges use New York, Baltimore, or Ohio providers when convenient.
This procedure: A screening bilateral mammogram is the routine X-ray check of both breasts in women with no symptoms, looking for cancers too small to feel. A technologist takes two standard views of each breast with brief compression; the visit takes about 20 minutes, and a radiologist reads the images afterward, with results sent within days. It is the test guidelines recommend at regular intervals starting in a woman's 40s.
What Is Screening Mammogram?
A screening bilateral mammogram is the routine X-ray check of both breasts in women with no symptoms, looking for cancers too small to feel. A technologist takes two standard views of each breast with brief compression; the visit takes about 20 minutes, and a radiologist reads the images afterward, with results sent within days. It is the test guidelines recommend at regular intervals starting in a woman's 40s.
What Affects the Cost
- –The screening itself is free under ACA preventive rules at in-network facilities, so out-of-pocket cost usually arises only from what follows.
- –3D tomosynthesis screening is an add-on code; most plans and Medicare now cover it as part of screening, but a few still pass its cost to patients.
- –Callbacks for additional views are billed as diagnostic mammography with normal cost sharing, and roughly one in ten screenings generates a callback.
- –Out-of-network facilities are not bound by the zero-cost-share screening rule.
- –Dense-breast supplemental imaging, like ultrasound or MRI, is billed separately and often with cost sharing.
Questions to Ask Before Booking
- 1.Is this facility in network so my screening is fully free?
- 2.Is 3D tomosynthesis included at no charge under my plan?
- 3.If I get called back for more views, what will that diagnostic visit cost me?
- 4.Am I inside my plan's allowed screening interval so the claim will not be denied for timing?
- 5.If I have dense breasts, what supplemental imaging might be recommended and does my plan cover it?
Other featured procedures in Pennsylvania
Screening Mammogram in other states
Screening Mammogram in Pennsylvania: questions
Under 2026 Medicare rates, a screening mammogram costs about $125 in Pennsylvania at an imaging center or office, from $118 in Rest of Pennsylvania to $131 in Metropolitan Philadelphia. In a hospital, the doctor is paid about $35 for the reading and the hospital bills separately for the test. Enter a ZIP for the exact Pennsylvania locality.
Yes. CMS splits Pennsylvania into 2 payment localities. For this CPT the office physician fee spans $13.15 from the lowest to highest locality. Look up your ZIP to see whether metro Philadelphia or rest-of-state pricing applies, from Philadelphia and its collar counties to Pittsburgh, Harrisburg, Allentown, Scranton, Erie, and the rural center.
After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $25 for the office physician line or $7 for the hospital physician line in Pennsylvania. Medigap may cover that 20%. This is not the hospital facility fee.
At an imaging center or office, $124.55 is Medicare's full rate in Pennsylvania, covering the test and the reading. In a hospital, the physician bills only the reading (about $35.20) and the hospital bills separately for the test. Pennsylvania ranks #28 of 51 states on this rate (within 2% of the national office rate of $126.26).