How much do cancer scans and tests cost — and what insurance covers

Short answer: In the US, with insurance, a diagnostic CT typically runs a few hundred dollars out of pocket, an MRI several hundred, and a PET/CT the most of the three — often $1,000 or more toward your deductible. Without insurance, hospital list prices for a PET/CT can reach five figures, though cash-pay and imaging-center prices are dramatically lower. The number that actually matters is not the sticker price: it's your deductible, your coinsurance, and whether the facility is in network.

Nobody warns you that a diagnosis comes with a billing problem attached. Here's how the money actually works, and the specific calls that lower the number.

Why the same scan has five different prices

A single scan has a list price (the hospital's chargemaster number, which almost nobody pays), a negotiated rate (what your insurer agreed to pay), a cash price (what you pay if you self-pay, often far less than list), and your out-of-pocket share (deductible plus coinsurance). Freestanding imaging centers are frequently a fraction of a hospital outpatient department's price for the identical scan on comparable equipment.

That gap is the single biggest lever you have. Ask your doctor: "Can this be done at a freestanding imaging center instead of the hospital?"

What drives your bill

| Factor | Why it matters | | --- | --- | | Deductible status | Early in the plan year, you pay nearly the full negotiated rate | | In vs. out of network | Out of network can multiply your share, or apply to a separate deductible | | Facility type | Hospital outpatient departments cost markedly more than freestanding centers | | Contrast | Adds drug and administration charges | | Professional fee | The radiologist bills separately from the facility — two bills, one scan | | Prior authorization | If it's missing, the claim can be denied entirely |

That last line causes more surprise bills than any other. Confirm prior authorization is on file before the scan, not after.

The five calls that lower the bill

1. Call your insurer (number on the card). Ask: is this CPT code covered, what's my remaining deductible, what's my coinsurance, is this facility in network, and is prior authorization required and on file?
2. Call the facility's billing office. Ask for the cash-pay or prompt-pay price and compare it to your expected insured cost. Sometimes cash is cheaper than running it through insurance — but note that cash payments usually don't count toward your deductible.
3. Ask your doctor's office for the CPT code before you call anyone. Prices quoted without a code are guesses.
4. Ask about financial assistance. Nonprofit hospitals are required to have charity-care policies, and many quietly discount balances for households well above the poverty line. Ask specifically: "What is your financial assistance policy and how do I apply?"
5. Ask about a payment plan before the bill goes to collections. Most systems offer interest-free plans; almost none advertise them.

If the claim is denied

Denials are frequently reversed. The process:

• Ask the insurer for the denial reason in writing and the specific policy language it cites.
• Ask your doctor's office to submit a letter of medical necessity and request a peer-to-peer review — your oncologist talking directly to the insurer's physician reviewer.
• File a formal internal appeal, then an external review if it's upheld. External reviews are handled by an independent body and overturn a meaningful share of cancer-related denials.
• Note deadlines. They're short and strict.

What financial help exists

• Hospital charity care / financial assistance — the largest and most overlooked source.
• Patient Advocate Foundation — case managers who negotiate bills and fight denials, free.
• CancerCare — limited financial assistance grants and free counseling.
• The Leukemia & Lymphoma Society, Susan G. Komen, American Cancer Society and other disease-specific groups — travel, lodging, and co-pay grants.
• Drug manufacturer patient assistance programs — for the treatment itself, often income-based and substantial.
• Clinical trials — the study typically covers the investigational drug and trial-specific testing, which can materially lower cost. See how clinical trials actually work.

Questions to ask before you agree to a scan

• What is this scan looking for, and what will change based on the result?
• Is there a lower-cost imaging option that answers the same question?
• Can this be done at a freestanding imaging center?
• Is prior authorization required, and is it on file?
• Will the radiologist bill separately, and are they in network too?

Before the bill arrives

If you already have an explanation of benefits or an itemized bill you can't decode, you can paste it into Cura for a plain-language breakdown and a list of the exact questions to ask billing — free, and nothing you upload is saved.

Related reading: what to ask after a cancer diagnosis, how to get a second opinion, and waiting for scan results.