How Expensive Is Skin Cancer Screening?

According to the American Cancer Society, skin cancer is the most common form of cancer. The American Academy of Dermatology (AAD) reports that 1 in 5 Americans will develop skin cancer at some point.

Fortunately, the two most common types of skin cancer — ​​basal cell and squamous cell carcinomas — are not difficult to treat if they are diagnosed early. Even melanoma, the deadliest form of skin cancer, has a 99% survival rate if it is caught before spreading to the lymph nodes. Once it spreads to nearby nodes, though, that rate drops to 66%.

That’s why early detection is important. The Skin Cancer Foundation recommends annual full-body skin checks by a dermatologist. Read on for a guide to such costs plus details on what to look for and when to consult a doctor. 

How is skin cancer diagnosed? 

The first step toward skin cancer diagnosis and treatment is for you to inspect your own skin regularly. According to the AAD, about half of melanomas are self-detected. Look for irregular new spots and changes in skin texture. Inspect any moles or skin lesions, paying attention to any changes in color, size, or shape, or any new growths on the skin. Itching or bleeding could also be a sign of skin cancer. The “ABCDE” (asymmetry, border, color, diameter, evolving) method can help you remember what to look for. 

If your doctor identifies a potential skin cancer lesion, they’ll call for a biopsy to find out whether that lesion is cancerous. A biopsy is when a skin sample is extracted for closer examination. 

Basal cell carcinoma and other superficial cancers rarely spread, so the removal of that lesion for the biopsy usually completes the treatment. For more serious cancers — such as large squamous cell carcinoma, Merkel cell carcinoma, or melanoma — you’ll often need additional procedures like medical imaging or a lymph node biopsy. These will reveal if the cancer has spread.

Which screening tests are usually needed for skin cancer? How much do they cost?

A dermatologist can perform a thorough visual screening for potential skin cancer. They will examine any unusual lesions and determine if a biopsy is necessary. To check you for melanoma, your dermatologist may also use a handheld magnifying device called a dermatoscope.

A multi-year study published in 2018 found that the average cost for a skin cancer screening visit was $150. Of that, $105 (70%) was for office-visit costs, and $45 (30%) was for biopsy and pathology costs. 

Where can you find free skin cancer screenings?

Organizations like the American Academy of Dermatology and the American Society for Dermatologic Surgery regularly provide free skin cancer screenings throughout the country. These screenings generally occur several times throughout the year and take place in clinics, outpatient centers, and even mobile units. 

You can also contact hospitals and low-cost clinics near you to ask about upcoming free screening events in your area. 

How much does it cost to see a dermatologist about skin cancer?

The typical cost for a dermatologist visit in the U.S. is $125. Many healthcare plans consider  dermatologists to be specialists, which means you may face a higher copay or coinsurance level than the one for your primary care provider. Check your policy documents for specifics.

If you’re on original Medicare, Part B will cover cancer-related dermatology services, including exams and biopsies — but you must have a specific area of concern, such as a suspicious lesion. You’ll also need a referral from your primary care physician. Routine dermatology visits, such as annual skin cancer screenings, are not covered by Medicare. 

How much does a biopsy cost, and when do you need one? 

If your doctor suspects skin cancer, they’ll generally call for a bit of your affected skin to be biopsied. The purpose of a biopsy is to examine the skin more closely to see if skin cancer is present. There are several different types of skin biopsy, including:

• Shave biopsy

• Punch biopsy

• Excisional biopsy

• Incisional biopsy 

After the doctor takes a sample of your skin, it’s sent to a lab, where a pathologist examines it. Depending on your provider and healthcare plan, you may be billed a separate fee for the pathologist. 

In some cases, a pathologist may bill out of network, increasing their fee. (One study of 2017 data found that 33% or more of pathologists have submitted at least one out-of-network claim for services to in-network patients.)  

However, if you’re insured through a private employer-based plan, you are shielded by the No Surprises Act. This new law defines pathology as an “ancillary service” that must be billed at in-network rates. 

Nationally, the median price for an outpatient skin biopsy is $188 for people with private insurance, according to a 2017 study in the Journal of the American Academy of Dermatology.

Medicare and some Medicaid plans cover skin biopsies, but you may have to pay coinsurance or a copay.

How often should you be checked for skin cancer?

The Skin Cancer Foundation recommends a screening once a year if you are not at high risk for skin cancer. You’re considered not to be at high risk if you have no history of skin cancer and your self-examination turns up no discernible lesions, moles that have changed, or other symptoms of skin cancer. 

But if you’ve had skin cancer in the past or are otherwise at high risk, being screened once a year may not be enough.

That’s because people with a history of skin cancer have an increased risk of developing it again. According to the American Society of Clinical Oncology, 35% to 50% of people who’ve been diagnosed with one basal cell carcinoma will have a new skin cancer within 5 years. 

The American Cancer Society recommends:

• For people who have had basal cell cancers: Screenings every 6 to 12 months. 

• For people who have had squamous cell cancers: Screenings every 3 to 6 months. 

• For people who have had melanoma: Screening frequency depends on the cancer’s severity. 

  • If the melanoma was caught early, schedule screenings every 6 to 12 months. 

  • If the melanoma had grown and spread before its removal, book a screening every 3 to 6 months for several years afterward.

Also, if you’ve had skin cancer before, your doctor may suggest monthly self-examinations of skin and lymph nodes. If you do find a questionable spot, see a dermatologist as soon as possible. 

How much does follow-up care cost? Do you need insurance for these appointments?

If you’ve had a skin cancer lesion removed, post-operative visits are generally covered as part of the global surgical package. The package’s follow-up care often includes an appointment for suture removal. It may also have one or two additional appointments so a healthcare provider can monitor your healing and progress.

If you have Medicare or health insurance through the national marketplace, your policy covers ambulatory (outpatient) care such as specialist visits. A copay or coinsurance will apply, though.

If you’re on Medicare and your follow-up dermatology visits are medically necessary, those visits are covered. You’ll pay coinsurance of 20% of Medicare’s specified fee.

Fortunately, you can get follow-up care even without insurance. Free or low-cost clinics and community health centers across the country can help identify whether a skin lesion needs further treatment. Some doctors will work on a sliding scale or negotiated fee for patients in need.

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Written by:

Laura Bolt

Laura Bolt is a writer and editor based in Los Angeles. Until 2015, she was a staff editor at Details magazine, where she worked on the culture, health, and features sections.

Edited by:

Caren Weiner, MSIS

Caren Weiner, MSIS, began her personal finance journalism career in 1986. She worked as a reporter for Money magazine and co-wrote its book-length “Guide to the 1986 Tax Reform Act.” From the beginning, she immersed herself in data on mutual fund total returns and marginal tax rates.

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