Mammogram Comments
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Posted by: DC customer in Washington, DC. | Posted: March 21st, 2012 08:03AM |
Clinic or Doctor: GT University Hospital | Insurance Carrier: Golden Rule UHC |
Type of Policy: Choice Plus |
This is just to comment on the post from a user in Boulder, CO. I live in Washington, DC and UHC Golden Rule clearly confirmed to me that annual AND diagnostic mammograms and breast ultrasounds are covered, no deductible applies (and they paid all my annual screenings and diagnostics for breast mammogram). Not sure why in CO they have a different coverage, probably, it's due to different consumer regulations in your state, or you may had used a non-network provider. However, if you go to any EU country, the cost of mammogram can not be less than EUR 150, which is still much more than $90 repriced amount of the Golden Rule network providers. I lived in Germany for a long time, and know their prices quite well. Therefore, the $90 negotiated network provider cost for mammogram from Golden Rule is a great deal, by any standards. |
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Posted by: Disgusted patient in seattle, WA. | Posted: March 8th, 2012 02:03PM |
Clinic or Doctor: Evergreen Hospital, Kirkland, WA | Insurance Carrier: None |
It was shocking to see two bills totaled $740.00 for a diagnostic mammogrạm. I wonder if there might be a conspiracy to rip patients off? I do not like Evergreen Hospital anymore, they are way too expensive!
Buyers beware of this |
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Posted by: a user UHC in Boulder, CO. | Posted: March 7th, 2012 06:03PM |
Clinic or Doctor: Boulder, Colorado | Insurance Carrier: Golden Rule |
Type of Policy: UHC One |
After I went for my routine annual mammogram, which was supposed to be covered by my insurance,as stated under the section 8:covered benefits of my policy, I got a bill. From the isurace I was told that it was reported as a doctors visit,a disease problem etc. rnAs I specifically requested, before I schedule my appointment that I would like to have my annual breast exam, the doctors office reported it as a disease problem. And when I called the doctors office, the medical assisstant told me they reported it as usual. The medical assistant promissed she will call my insurance to confirm it was annual breast exam so I could have it covered. From the insurance: she's been told that I was charged because I didnt meet my deductable, and the previous year I had it covered because I had met my deductable. (This is not true because I went to a doctor only once in 2010 - for the mammogram, and I had it covered). In the policy its is stated that I can have one routine or diagnostic mammogram per calendar year as a covered benefit and does not go against the deductible.rnIn 2012, in the difficult times, it isn't. (Why am I surprised? My fault). rnI went to Europe and had everithing done perfect for about 30 dollars, no problems, no unexpected bills. rnI didnt have the mammogram done in Boulder Community Hospital(a hospital from the UHC network), when I found out that I will be charged for the doctors visit, as I suspected they won't cover it. And I was right. I ended up paying only the repriced amount of $95 for the doctors visit. So I had the job done in EU. :))) |
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Posted by: Happy Patient in Washington DC, DC. | Posted: February 22nd, 2012 07:02AM |
Clinic or Doctor: Georgetown University Hospital | Insurance Carrier: Golden Rule UHC Choice Plus |
Type of Policy: dont know |
I had 2 mammograms done, one preventive, another diagnostic, because the first one showed a shadow and they needed to take another look (which turned out to be nothing). The network provider negotiated cost was around $100 per each procedure, which I would have no problem paying, but Golden Rule has a new policy that BOTH preventive and diagnostic mammos are covered no deductible, so I ended up paying zero. Very happy so far with my insurance. They also pay for breast ultrasound with no deductible. |
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Posted by: BreastImager in Ann arbor, MI. | Posted: February 16th, 2012 06:02PM |
Type of Policy: Bcbs |
Much of the info posted on this site is based on an individuals view of the system--from the outside. These billing issues are very complicated and constantly changing.
Bottom line: if you tell your doctor or technologist that you have a breast complaint, if you are recent breast cancer patient or you had previous abnormal mammo recommending follow up, then you are DIAGNOSTIC and copays and deductibles apply. If you are asymptomatic and have no recent surgery or abnormality on mammo then you can be a SCREENING which under obamacare is a covered preventative service. The imaging center and the radiologist get paid nearly the same for each type of exam regardless. Unfortunately, due to this artificially created distinction between exam types, the patient feels a huge difference as the preventive exam is "free" to you. If everyone voiced their opinion to their politicians we could maybe get this changed. This is going to get worse with the new government task force recommendations. |
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Posted by: a user in Boulder, CO. | Posted: February 11th, 2012 01:02PM |
Clinic or Doctor: Alpine Surgical LLC | Insurance Carrier: United Healthcare |
Type of Policy: Golden Rule HSA |
The routine breast exam pre calendar year listed as a benefit in my policy as a benefit is bulshit.
They lied and told me diferent stupid lies. In 2010 this exam was covered, this year they ask me to pay. I canceled my insurance. I wouldn't go to Alpine Surgical ever again. |
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Posted by: Karen Russo in Marlboro, NJ. | Posted: January 20th, 2012 08:01AM |
Clinic or Doctor: Freehold Radiology | Insurance Carrier: Horizon Blue Cross of NJ |
Type of Policy: Direct Access HSA |
Spent an hour on the phone with gyno, radiologist and ins. co. Went in for a routine gyno exam, and doctor felt a fibrocystic area on left breast. So he wrote RX for a routine mammo and a diagnostic ultrasound just to be safe. I am entitled to one routine mammo per year under my insurance, but I am not sure if it will be covered because gyno wrote routine and a diagnostic code. Very frustrating as I could not get an answer from insurance carrier. Told me it would be paid depending upon how the radiologist billed the claim!!!??? |
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Posted by: Donna Elliott in wilmington, DE. | Posted: December 7th, 2011 09:12AM |
Clinic or Doctor: Brandywine Imaging | Insurance Carrier: BCBS Regence |
Type of Policy: ppo |
Have been going there for 11 years for annual screening never paid anything because ins. covered 100% screening. This year was in and out faster than ever and got a bill for an additional view coded as a medical mammo in addition to the annual screening so not part of the 100% a doc never ordered this and all was normal they say the tech must have thought it was needed, so i asked if i will need to stop a tech after 4 images so i will not have to pay for additional mammo going forward she said "well if you are comfortable with that"..something is so wrong here. |
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Posted by: Pam Vernon in HIGH POINT, NC. | Posted: September 9th, 2011 05:09AM |
Clinic or Doctor: PREMIER IMAGING LLC | Insurance Carrier: UMR |
Type of Policy: PPO |
I had my annual MAMMO and I paid absolutely NOTHING!!!! I had a greaaaaat experience and will be going back there each year. |
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Posted by: a user in STAMFORD, CT. | Posted: September 6th, 2011 11:09AM |
Clinic or Doctor: STAMFORD HOSPITA' | Insurance Carrier: CIGNA |
i THINK IT SHOULD BE A PREVENTATIVE WITHOUT PAYING THE 400.00 DEDUCTIBLE |
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Posted by: LuzMery Pelaez in stamford, CT. | Posted: August 27th, 2011 07:08AM |
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Posted by: a user in Cumming, GA. | Posted: May 20th, 2011 09:05AM |
Clinic or Doctor: Northside Hosp GA | Insurance Carrier: United Healthcare |
Type of Policy: PPO |
Went for a yearly Gyno visit and doctor said I was due for mommorgram. Noted I had slight soreness in left breast so she wrote for a 'diagnostic" mam. instead of a "screening" mam. Screening is free but apparently diagnostic costs $776! Thank goodness no cancer but feel completely hoodwinked and cheated. Put off getting a mammo because I did't have any money for copay. This year though my 100% coverage for yearly screening would be a great time for mammo. Guess I am just another uneduacted consumer. Follow up in 6 months? Not likely. |
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Posted by: yy in Duluth, GA. | Posted: April 7th, 2011 12:04PM |
Clinic or Doctor: Northside Hospital GA | Insurance Carrier: Blue cross |
Type of Policy: ppo |
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Posted by: effie in Bronx, NY. | Posted: March 31st, 2011 05:03AM |
Clinic or Doctor: Doctor/Hospital | Insurance Carrier: Medicare |
Type of Policy: Medicare |
My mammogram indicated I have breast calcifications in both breasts and the doctor said I required a biospy, which I had in the right breast, but no cancer was found. The procedure left a big scar. I am appalled that my doctor didn't tell me before the biopsy that having it could result in scar tissue would which require mammograms every six months, and my cancer risk has increased now because of the biopsy. The doctor wanted to biopsy my other breast and I refused so now she is mad, and I will not go for any more mammograms since I am 82 years old. These doctors should be ashamed of themselves for not telling the patient the whole story about these procedures because they want to make more money. |
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Posted by: joanM in milwaukee, WI. | Posted: March 28th, 2011 08:03AM |
Clinic or Doctor: Columbia St. Mary's | Insurance Carrier: Assurant |
Type of Policy: family/individual |
I've a $10,000 deductible so I tried to get a price on a DIAGNOSTIC mammogram for calcifcations. Columbia, which I've used before, Froedtert, and Aurora all refused to quote a price except for the procedure itself--they absolutely won't quote on the radiologist's or other fees. No way to check if the $684 I was quoted is a real number or if the woman in pricing just made it up on the spot. Yeah, Republicans and their "consumer driven" health care. @@ The patient advocacy ctr. that contracts with Assurant told me many women with high deductibles just lie and say they have no insurance so they can get a solid price. |
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Posted by: Cancer Survivor in Irvine, CA. | Posted: February 18th, 2011 08:02PM |
Clinic or Doctor: n/a | Insurance Carrier: n/a |
Type of Policy: PPO |
October 2010 they found cancer in my right breast during a diagnostic screening, it was small in size but a deadly spreading sort caught very early. I had insurance then but do not this year for follow up testing. I, nor you, should be playing Russian Roulette with breast cancer because of the costs. I skipped a year of yearly mammos and on the second year they found breast cancer. It is not anything to take lightly or place money first. Catch it early, pay for the tests, and be happy that it was nothing if you are so lucky. It is worth every hard earned penny to be tested. I have also had kidney cancer, again found very early and the most lethal of the urological cancers. Get tested at all costs. This year I will be paying dearly, and praying dearly, that cancer is not found. Insurance companies and health services are maddening, but I will take the hassle they bring over the reality of a cancer to fight. |
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Posted by: KT1977 in Las Vegas, NM. | Posted: February 17th, 2011 05:02PM |
Clinic or Doctor: SF Imaging Clinic | Insurance Carrier: none |
Type of Policy: none |
Out of pocket. Recommended by my PCP, because she knew I didn't have insurance. Had to drive 1 hour to Santa Fe, but $100 less than local hospital. Worth the trip! |
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Posted by: Bewildered by UHC in AK in Anchorage, AK. | Posted: January 19th, 2011 09:01PM |
Clinic or Doctor: Providence Imaging | Insurance Carrier: United health care |
Type of Policy: PPO |
My insurance (United Health Care) does not cover screening mammograms if you "choose" a provider who is out of network. And United Health care does not have a network in Alaska! So I paid the full price, and found out I had early stage breast cancer. I hope that all women will find a way to get this done. Do your research, look for places that might offer a discount or even free if you don't have the money. Don't let the hassle and frustration over cost make mammograms something you avoid, they can save your life! |
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Posted by: susi in allen, TX. | Posted: December 10th, 2010 05:12AM |
Clinic or Doctor: viterbo italy | Insurance Carrier: none |
Type of Policy: none |
i recently had a mammogram and ultra sound in italy for $55 dollars while on a trip. great doctors, great prices, no wait. the ama is lying about medical care in europe- it is fantastic and cheap sinece it is they have both public/private systems(only foreigners use private) because the public services are so good. mine was at a private clinic. |
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Posted by: msprissysmom in Lawton, OK. | Posted: November 3rd, 2010 08:11AM |
Clinic or Doctor: Comanche Imaging Center | Insurance Carrier: None |
Type of Policy: None |
No insurance and it runs in the family real bad and turning 49 thought I should have 1, haven't had it done yet, but thought I would google it to find out something less expensive. |
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Posted by: VB in Lake Orion, MI. | Posted: August 13th, 2010 09:08AM |
Clinic or Doctor: crittenton | Insurance Carrier: BCBS |
Type of Policy: PPO |
The total bill is $1506 and insurance paid $1193. I will be making a lost of calls on this. No wonder insurance is so expensive |
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Posted by: outraged in SF Bay Area California in Concord, CA. | Posted: July 30th, 2010 04:07PM |
Clinic or Doctor: John Muir Hospital, Concord | Insurance Carrier: Health Net |
Type of Policy: PPO |
Just got the bill for the annual screening exam. The hospital is charging $723, and the Dr. charges $144 to read the Xrays. I feel that is outrageous. My insurance disallows part of the hospital xray charge, bringing it down to $469.95. And reduces the reading charge to $56.87. That is still outrageous, and with a high deductible, all out of my pocket. Next year I will use a CLINIC instead of the hospital. I found six clinics in my area that charge $300 for the standard screening mammograms. |
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Posted by: responsible party in miami, FL. | Posted: July 12th, 2010 12:07PM |
Clinic or Doctor: miami breast institue | Insurance Carrier: assurant |
Type of Policy: forgot |
BIG TIME SCAM THEY SHOULD BE A SHAMED OF THIS , NOT ONLY DID I SPEND THE $250. 00 dollars on top of that ,as my 20% here how this reads, screening mammo dig $400.00 , cad screening $105.00 ultrasound pelvic -tra $475.00, ultrasound,pelvic $495.00, and yes i fell for the call back , which was another , out of my pocket of $133.00 but iam not finished , sorry i can not pay for this they really need to post the prices and have some type of sliding scale , health care we need , early heart attacks not yet , and they need to give a itemized bill at the end of office visit , shop around for a better price |
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Posted by: pissedoffmedstudent in Richmond, VA. | Posted: July 8th, 2010 11:07AM |
Clinic or Doctor: n/a | Insurance Carrier: n/a |
Type of Policy: n/a |
You should shop around first. Then once you find a price that you like, get them to put it in writing first before you get the procedure (then if you get something different on a bill you can have something to back you up, especially if you have to go to court for not paying). You have a right to know just how much something is going to cost you before you get it, especially if you have to pay at the time of service. If you go in person it will also be easier to get a real price because you will be able to see the lies when you hear them (ask to speak to someone in billing for the real total cost and make an appt if you have to). And remember that if you really feel that you have been overcharged and especially if you have evidence of wrongful billing/procedures, you can always count on the labor board to get it straight. |
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Posted by: yls in mpls, MN. | Posted: June 24th, 2010 07:06AM |
After reading all the horror stories, at age 80 I'll forgo a mamogram, so much for all the coverage I think I have, there must be a cure for cancer and predatory pricing. |
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Posted by: Lucy A in Waco, TX. | Posted: June 10th, 2010 06:06PM |
Clinic or Doctor: Scott & White Waco Texas | Insurance Carrier: N/A |
Type of Policy: N/A |
I just got back from my mammogram and was floored when I seen my bill it was 638.00 after they took the 40% off. I really cried then I just couldn't hold back the tears. Allthough they were very nice there and I had a mammogram and an ultasound because they found something it was over $1000.00 minus the 40% for paying in full. Anywho, Im glad I went because it was needed Im 43, I found a lump and I have never had one before so I went, I did call first to find out how much money it would cost me and she said the mammogram starts around $180.00 so you can see I was shocked with $638.00 So regardless all women need one and forsure do your self exams every month. |
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Posted by: SeemsReasonable in Appleton, WI. | Posted: June 8th, 2010 07:06PM |
Clinic or Doctor: Theda Clark | Insurance Carrier: United |
Type of Policy: High Deductible |
Billed $190 for basic screening and insurance paid all. This was covered under "preventative care." However, billed $204 for follow up diagnostic, network reduced to $152. I paid the $152 because diagnostic is not part of preventative. The follow up (one view) including reading from radiologist took less than 15 minutes. No family history so I go every other year. 44 years old. |
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Posted by: Faye in Tarzana, CA. | Posted: May 28th, 2010 08:05AM |
Clinic or Doctor: Providence Tarzana Medical Center | Insurance Carrier: United Health Care |
Type of Policy: PPO |
This is the first time in my life I have had insurance which I am not crazy about that has a high deductible, but it is a PPO. However in 2009 with this same insurance I had a colonoscopy, not the doctor or the facility tried to gouge me. This place did for the mammogram. I would have done better to tell them I had no insurance anymore. My insurance made them adjust this bill only by $184.50 so I still owe $265.50. I think they are trying to gouge patients due the health reform bill passing and make as much money as they can till they cannot anymore. My dad now deceased co created and co wrote Medicare and Medicaid working for the Government. Last year at another facility in Glendale, Ca the price before the insurance was about half of this. I chose to have it as this place because I bought a house and this is much closer to my new home. What a mistake to not ask for a price before hand, shop around or pretend to not have any insurance. To add insult to injury on their bill to me is an offer for a $100 mammogram in May and the coupon good till Dec. 31, 2010! Of course too late for me and they would have never told me this in April when I went in for my yearly. This is disgusting behavior. I would hate to go to medical school and work at a place like this, treat patients like this and have to look myself in the mirror. |
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Posted by: Sucky Insurance! in Tucson, AZ. | Posted: May 4th, 2010 10:05AM |
Clinic or Doctor: Radiology limited | Insurance Carrier: BCBS |
I got a mammogram done in feb. and was billed for routine costing $291 and a CAD (2 additional x-rays) $63. I was told by radiology limited it would be billed medically nessecary since my mother was dx at age of 34 and later died at 40. Not the case. BCBS is refusing to see it as medically nessacary. They rather pay for my chemo and bone marrow transplant than a couple hundred dollars every year for a screaning. I got a mammogram when i was 26 under UNITED insurance and i didnt pay a dime. What is this world comming too. I'm so mad! |
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Posted by: d hornback in Lubbock, TX. | Posted: April 23rd, 2010 02:04PM |
Clinic or Doctor: Grace Medical lubbock tx | Insurance Carrier: |
I got a regular mammogram form this clinic in Lubbock Texas and the cost was over 1000.00.
I was unaware of the cost as the year before I went to the normal place for 250.00
I am not going back. |
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