Last updated: March 2026
How Much Does Mastectomy Cost?
Cost Breakdown by Type
| Type / Procedure | Without Insurance | With Insurance |
|---|---|---|
| Simple Mastectomy | $10,000 – $20,000 | $2,000 – $5,000 |
| Modified Radical Mastectomy | $15,000 – $30,000 | $3,000 – $6,000 |
| Double Mastectomy | $20,000 – $45,000 | $4,000 – $9,000 |
| Mastectomy with Immediate Reconstruction | $20,000 – $50,000 | $4,000 – $10,000 |
CPT/ADA Code: 19303
What Affects the Cost
- Brand-name vs. generic availability
- Insurance formulary tier placement
- Pharmacy choice (retail vs. mail-order vs. Costco)
- Manufacturer savings cards and coupons
- Dosage and quantity prescribed
- Geographic location
Insurance Coverage
Typical coverage: Medically necessary — covered for breast cancer; reconstruction covered under federal law
Most insurance plans use a tiered formulary: Tier 1 (generic) $0-$15 copay, Tier 2 (preferred brand) $25-$75, Tier 3 (non-preferred brand) $50-$150, Tier 4 (specialty) $100-$500+. Prior authorization may be required for certain medications. Step therapy may require trying cheaper alternatives first.
How to Save Money
- Always ask for generic when available — saves 50-90%
- Use GoodRx, RxSaver, or similar discount cards
- Costco pharmacy is open to non-members and often has lowest prices
- Mark Cuban's Cost Plus Drugs offers transparent low pricing
- Manufacturer patient assistance programs provide free medication to qualifying patients
- HSA/FSA funds can cover medication costs tax-free
Related Procedures & Costs
Frequently Asked Questions
A mastectomy costs $10,000 to $30,000 without insurance. Adding reconstruction increases total cost to $20,000-$50,000.
Yes, the Women's Health and Cancer Rights Act requires insurers to cover breast reconstruction after mastectomy, including implants and nipple reconstruction.
Most patients stay in the hospital 1-3 days. Recovery takes 4-6 weeks, with drain removal in 1-2 weeks.