Survey shows mammogram prices steady; assistance available

Latisha Dinish faced a diagnosis of fast-growing breast cancer with a big extra worry.   She needed treatment, but had no way to pay for it. She was unemployed and uninsured. "It was one horrible mess," said Dinish, 41, of Detroit.

Friends and a state welfare worker referred her to the Barbara Ann Karmanos Cancer Institute in Detroit.

Last year, the institute helped 700 women, including Dinish, pay for breast cancer screening and treatment with money raised from Detroit's annual Race for the Cure walk and run. The money is limited to women whose cancer is found through routine screening at the institute.

For a year, Karmanos has paid the COBRA for Dinish's health insurance, which covers her chemotherapy and radiation.

A former supervisor for an automotive supply firm, Dinish hopes more programs are made available to out-of-work women like her.

"Breast cancer is an epidemic; women need help," said Dinish, whose breast cancer spread to 16 lymph nodes under her arm. She tells women to find some way to get a mammogram.

While there's still no single program that helps all women, more Michigan mammography facilities offer discounts or are holding down prices. An annual mammography guide, produced since 2001 by the Detroit Free Press and the American Cancer Society's Great Lakes Division, also provides help for women shopping for an affordable mammogram.
Help with costs available; many eligible

Can't afford a mammogram?

Dozens of Michigan mammography facilities are offering discounts to uninsured and underinsured women or holding down prices to help women get their annual test.

"We can't let women go without just because they can't afford it," said Dr. Randy Hicks, co-owner and vice president of Regional Medical Imaging.

The large Flint and northern Oakland County radiology practice offers women who are uninsured or underinsured a $62 conventional film-screen mammogram and a $107 digital mammogram.

Regional Imaging centers began offering the discounted rates earlier this year because of the recession, Hicks said.Elsewhere, centers are holding down costs or barely raising them, despite installing costly new digital mammography equipment, according to an annual survey of 313 Michigan mammography facilities conducted by the Detroit Free Press and the American Cancer Society, Great Lakes Division.

The survey also provides information about waiting times for appointments; policies on acceptance of Medicare patients; wheelchair access, and other issues. (For the full survey, go to freep.com/data.)

Statewide, the median cost of a film-screen, or so-called analog, mammogram is $171, and $325 for a digital test, the survey found.

Prices for a film-screen mammogram are lower than the state median in Wayne, Oakland and Macomb counties, and vary widely center to center. Some are as low as $60 for a film-screen test; digital exams can exceed $600, the survey found.

That's why it's important for women who aren't fully insured or who are uninsured to look for places that offer discounts or more affordable prices, said Vicki Rakowski, executive vice president of the Cancer Society's Great Lakes Division.

Rakowski took issue with findings in a recent Journal of the American Medical Association editorial that questioned the value of mammograms because studies have not found a sufficient drop in deaths caused by breast cancer.

Mammography remains the best way to find breast cancer, Rakowski said. "Right now, we don't have answers to make any different decisions, and the decision is, yes, get a mammogram."

Ann Capitan, 65, of St. Clair Shores adheres to the Cancer Society's guidelines and has gotten a mammogram every year, including one Tuesday at Henry Ford Macomb Hospital in Clinton Township.

"I'm one of those people who takes care of my health," she explained. But she also had a scare about nine years ago when an initial, or screening, mammogram found something suspicious. A biopsy found no traces of cancer, but "once you go through that, you are faithful getting one," she said.Wanda Francisco, mammography supervisor at Henry Ford Macomb, said the number of women getting yearly mammograms is dropping slightly, as is the case at many other centers, because "so many people are losing their insurance." The center works with uninsured and underinsured women to provide low-cost mammograms, but she, like many mammography supervisors, declined to give details, fearing they might be inundated.

This year, 27% of Michigan mammography facilities declined to provide pricing information for the Cancer Society/Free Press survey, the most ever. The number of facilities that did not provide cost information increased from 8% in 2005.

Many of the facilities declining to provide cost information are very large hospital systems, including St. John Health, Warren; Beaumont Hospitals, Royal Oak, and Oakwood Healthcare, Dearborn.

Dr. Murray Rebner, chief of breast imaging at Beaumont Hospital-Royal Oak, said the hospital system declined to provide prices this year because the charges are not representative of the costs women actually pay, depending on their insurance.

He called listing of an average charge meaningless, since what an insurer pays for a mammogram depends on the discounts it can negotiate with a health center. Large insurers like Blue Cross Blue Shield of Michigan, which covers 7 of every 10 insured people in the state, often can get lower rates because they can send so much business to a health center.

However, many centers lose money on mammography because insurers don't fully reimburse for the test. Blue Cross Blue Shield of Michigan, the state's largest insurer, pays $110.31 for a film screen mammogram and $175.72 for a digital one.

In the past, uninsured women paid the full cost for a test, and that's what is changing. Still, uninsured women should ask for a discount to be sure they are not charged the highest price, Rakowski said.

Rebner said Beaumont now offers a $185 digital mammogram to uninsured women and plans to drop mammography prices by Jan. 1. "We feel women need to have access to breast imaging at a lower price," he said.

Paulette Valliere, program director for Michigan's Breast and Cervical Cancer Control Program, which offers free mammograms to uninsured women, said that despite the state's budget problems the program hopes to serve 30,000 women this year.

"It's a drop in the bucket," she said.