Screening Mammogram Cost in Wisconsin
Scr mammo bi incl cad
$120.91Wisconsin 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
Wisconsin Medicare physician rate (2026)
-4.2% vs nationalSingle statewide locality.
Your ZIP in Wisconsin
Check your ZIP code for your part of Wisconsin, whether Milwaukee, Madison, Green Bay and the Fox Valley, La Crosse, Eau Claire, or the rural Northwoods.
What screening mammogram costs at hospitals near you
Everything above is a national average. The hospital you pick in Wisconsin 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 Wisconsin
Where Wisconsin ranks for this CPT
Screening Mammogram and how Wisconsin is priced
Wisconsin's Medicare pricing runs through a single statewide locality with indices near the national average, so Milwaukee, Madison, and the Northwoods share the same approved amounts. The unified locality sits atop one of the more regionally organized care systems in the country, with strong integrated groups serving defined territories. No metro premium exists in the fee schedule, so Milwaukee's higher practice costs are averaged into the statewide factors. The published rates here travel unchanged across all seventy-two counties.
Milwaukee and Madison hold the state's academic medicine and largest systems, while integrated clinics in Marshfield, La Crosse, and the Fox Valley have long histories of serving rural Wisconsin through hub-and-spoke networks. The far north is lake and forest country where specialty care means a long drive south, and some western residents use Twin Cities or Rochester, Minnesota providers. Wisconsin's tradition of clinic-based integrated care tends to keep billing relatively coordinated.
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 Wisconsin
Screening Mammogram in other states
Screening Mammogram in Wisconsin: questions
Wisconsin is a single Medicare locality for this fee schedule. The 2026 physician rate for CPT 77067 is $120.91 in an office and $120.91 in a hospital, statewide. A ZIP lookup still confirms the locality mapping.
Not on the physician fee schedule. Wisconsin 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 $24 for the office physician line or $24 for the hospital physician line in Wisconsin. Medigap may cover that 20%. This is not the hospital facility fee.
No. $120.91 is the Medicare physician allowed amount for CPT 77067. Anesthesia, facility fees, implants, and other CPT codes billed the same day are extra. Wisconsin ranks #21 of 51 states on this physician line (4% below the national office rate of $126.26).