How Much Does a Screening Mammogram Cost in Rhode Island?
Scr mammo bi incl cad
$129.84Rhode Island physician fee2026 Medicare office rateUnder 2026 Medicare rates, a screening mammogram costs about $130 in Rhode Island at an imaging center or office. In a hospital, the doctor is paid about $36 for the reading and the hospital bills separately for the test.
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Rhode Island Medicare physician rate (2026)
+2.8% vs nationalSingle statewide locality.
Your ZIP in Rhode Island
Enter a ZIP code for your part of Rhode Island, whether Providence and Pawtucket, Warwick and Cranston, Newport, or the South County shore towns.
What screening mammogram costs at hospitals near you
Everything above is a national average. The hospital you pick in Rhode Island 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 02801.
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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 Rhode Island the office and hospital physician lines for this CPT differ by $94.15.
National vs Rhode Island
Where Rhode Island ranks for this CPT
Screening Mammogram and how Rhode Island is priced
Rhode Island, the smallest state, is unsurprisingly a single payment locality, with geographic adjustments above the national average in line with southern New England's cost structure. Providence and the shoreline towns publish identical Medicare-approved amounts, and no point in the state is more than an hour from its main hospitals. The compact geography makes locality subdivision pointless. Pricing here reads as a slightly discounted echo of neighboring Boston's market.
Providence dominates Rhode Island care, with the state's teaching hospitals and academic affiliation concentrated there, and consolidation has left a small number of systems running most beds. Many Rhode Islanders, particularly in the northeast corner, use Boston hospitals for complex or specialized procedures, accepting metro Boston pricing when they do. South County residents have fewer local options and often travel to Providence.
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 Rhode Island
Screening Mammogram in other states
Screening Mammogram in Rhode Island: questions
Under 2026 Medicare rates, a screening mammogram costs about $130 in Rhode Island at an imaging center or office. In a hospital, the doctor is paid about $36 for the reading and the hospital bills separately for the test. Rhode Island is a single Medicare locality, so the physician rate is the same statewide.
Not on the physician fee schedule. Rhode Island 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 $26 for the office physician line or $7 for the hospital physician line in Rhode Island. Medigap may cover that 20%. This is not the hospital facility fee.
At an imaging center or office, $129.84 is Medicare's full rate in Rhode Island, covering the test and the reading. In a hospital, the physician bills only the reading (about $35.69) and the hospital bills separately for the test. Rhode Island ranks #39 of 51 states on this rate (3% above the national office rate of $126.26).