- It depends. Your annual mammogram could be either a screening or a diagnostic mammogram. A screening mammogram is usually covered completely by insurance as part of your “preventive” package.
- A diagnostic mammogram, however, is processed through your insurance company as a diagnostic exam, so you may have out-of-pocket expenses, based on your copay arrangement and whether or not you have met your deductible for the year.
Screening mammography plays a central role in early detection of breast cancer because it can show changes in the breast up to two years before a patient or doctor can feel them. A screening mammogram involves taking two views of each breast for a total of four views. Your study will normally be read within two weeks.
A screening mammogram is recommended every year beginning at age 40. If you have significant risk factors, your doctor may recommend earlier screenings.
If you have any of the conditions below, please talk to you doctor about a diagnostic mammogram.
You do not qualify for a screening mammogram if:
- You’ve had a lump, nipple discharge or any other change in your breast in the past three months.
- You’ve had a mastectomy, breast surgery or a needle biopsy in the past three to six months.
- You’ve had a breast implant rupture or leakage.
- This mammogram is a six-month follow-up.
Diagnostic mammography is used to evaluate patients with risk factors, abnormal clinical findings—such as a breast lump(s) and breast pain—or personal history that warrant a diagnostic study. Diagnostic mammography may also be done after a screening mammogram shows abnormal results in order to determine the cause of the area of concern. During a diagnostic mammogram, additional views may be taken of each breast. The study will be reviewed immediately by a subspecialist imaging doctor, and the results will be available to your doctor the same day. This type of mammogram will be sent to your insurance company as a diagnostic study. Whether you have a deductible or copay due depends on your specific plan.
- When you have your mammogram, you will receive 2 bills:
- A Cedars-Sinai bill for the technical portion.
- A bill from the Imaging physician group who interpreted your study.
- The hospital sends one bill for all visits on the same day. The consolidated statement may list charges for your visit to the Saul and Joyce Brandman Breast Center—A Project of Women’s Guild and will also itemize the charges related to the breast imaging exam you completed. A separate bill will be sent by your doctor and the imaging doctor.
If you have questions about your Cedars-Sinai bill, please contact:
- Cedars-Sinai Business Office: 323-866-8600
If you have questions about the subspecialized Imaging Physician’s separate bill, please contact:
- Cedars-Sinai Imaging Medical Group: 800-303-3044
To schedule an appointment, please call 310-423-8000.