High Scanxiety, Higher Bills—But High Hopes

“Next time you’re found with your chin on the ground…”

That’s been me before breast MRIs.

Tomorrow, I get into the tube. It’s a particular kind of fear—loud and inescapable, though strangely musical too. More than that, it’s the kid gloves and pity-kindness of the people at the facility, who mean well but don’t seem to know which side of diagnosis I’m on because coverage of these scans is unusual for those not already diagnosed. It freaks me out. In my book, I wrote about how stressful and strange these scans have felt. That hasn’t magically disappeared. But something has shifted.

The world has changed, and so have I.

We know more now. We know that mammograms can miss tumors, especially in dense breast tissue. We know ultrasounds help—but they’re not the whole picture. And we know that MRIs, for all their intensity, can play a critical role in early detection. My radiologist—who I respect trust—has slowly, patiently turned my thinking around about MRIs. I am fortunate to have the choice to do them and I’m lucky I have the coverage.

Still, the scanxiety is real.

I’ve done the work to manage it. I know I can face whatever comes. I don’t believe I’m going to die of breast cancer anytime soon—if something is there, we’ll catch it early. I’m in menopause. I’m being vigilant and trying to use all the tools at my disposal.

And yet.

Then there’s the cost.

My copayment will be $300. The scan itself will be billed at over $20,000. That’s not a typo. At a recent book event in Florida, a physician told me her center offers MRIs for $400 cash. Four hundred. So what, exactly, are we doing here?

These aren’t real prices. They’re negotiating tactics. Inflated numbers designed to push insurance reimbursements higher, while patients float somewhere in between trying to make sense of it, bracing for the “surprise” invoice that comes later. The last time I did this, it was billed at $18,000. I paid my $300 copay… and then another nearly $1,000 afterward. It’s a game.

But something amazing happened that has changed my air.

A week ago, I was invited to participate in a clinical trial at my imaging center. They’re studying whether breast MRIs can be done effectively without contrast dye. Tomorrow, I’ll do the scan without it first, then again with it for comparison.

If it works—if the study finds that the images are just as good—it could mean less time, less cost, less anxiety. No IV. Fewer side effects. (For me, the dye has always meant a headache, nausea, and that unmistakable chill). It’s a small change on the surface, but it has the potential to ripple outward in ways that matter—for access, for experience, for care. For more women.

It’s not a fix for all that is wrong with the system. But it’s something.

I keep thinking about the lines written by the legendary Sammy Cahn— 

When troubles call

And your back's to the wall

There a lot to be learned

That wall could fall. 

I feel this way. Not because I’m newly fearless, but because showing up to help in this trial feels like my own quiet act of hope. Hope that the system is evolving. Hope that one day, this kind of care won’t feel like both a privilege and a stressor.

High hopes.