Bone Density Test (DEXA): What It Measures and Where to Get One
A DEXA bone density test is how doctors diagnose osteoporosis before a bone breaks. What your T-score means, when insurance and Medicare pay, what a cash-pay scan costs, and where to get one.
Medically reviewed by Dr. Emily Chen, MD, FACP · Updated August 19, 2026
The short answer
A bone density test (DXA or DEXA scan) is a painless, 10–15 minute low-dose X-ray of your hip and spine. It measures bone mineral density and reports it as a T-score, the number that tells you whether you have normal bone, osteopenia, or osteoporosis.
With a physician's order, insurance and Medicare typically cover it. Booked on your own, cash-pay scans at independent clinics generally run $99–$250. Hospital imaging departments often charge $300 or more for the same test.
What a Bone Density Scan Measures
A DEXA bone density scan passes two low-dose X-ray beams through your lumbar spine and hip, the sites where osteoporotic fractures do the most damage, and measures how much of the beam your bone absorbs. From that it calculates your bone mineral density in grams per square centimeter (g/cm²).
Your report translates that raw density into three things your doctor actually uses:
- Your T-score, which compares your density to a healthy young adult's peak bone mass. This is the diagnostic number.
- Your Z-score, which compares you to people your own age and sex instead. For younger adults this is the more relevant benchmark.
- A fracture-risk assessment: spine and hip measurements feed tools like FRAX that estimate your 10-year fracture probability.
The scan is quiet and you stay fully clothed. The radiation dose is about a tenth of a chest X-ray, low enough that repeating the test every year or two is considered safe.
Understanding Your Results: T-Score and Z-Score
The World Health Organization defines bone health in T-score bands. Wherever your number lands, review it with your physician, because treatment decisions weigh your full fracture-risk picture rather than the score alone.
| T-score | What it means | Typical next step |
|---|---|---|
| -1.0 and above | Normal bone density | Routine re-screening on your doctor's schedule |
| Between -1.0 and -2.5 | Osteopenia (low bone mass) | Lifestyle measures (weight-bearing exercise, calcium and vitamin D) plus monitoring; medication in higher-risk cases |
| -2.5 and below | Osteoporosis | Physician evaluation for treatment to reduce fracture risk |
The Z-score on the same report compares you to your age group instead. A Z-score below -2.0 in a younger adult suggests bone loss beyond what age explains and usually prompts a workup for an underlying cause.
Who Should Get Osteoporosis Screening
Osteoporosis is silent until a bone breaks, and roughly half of women and a quarter of men over 50 will have an osteoporosis-related fracture. Screening exists to catch bone loss while it's still treatable. The U.S. Preventive Services Task Force recommends bone density screening for:
- All women 65 and older, regardless of risk factors.
- Postmenopausal women under 65 at increased risk: low body weight, smoking, excess alcohol use, a prior fracture, or a parent who fractured a hip.
Beyond the formal guideline, clinicians commonly order a bone density test for men over 70, anyone with a fragility fracture after age 50, and people on medications or with conditions known to thin bone, such as long-term corticosteroids, aromatase inhibitors, hyperthyroidism, and celiac disease.
If any of those describe you and you've never been scanned, it's a short conversation with your doctor, and a short test.
Bone Density Test Cost: Insurance vs Cash
Bone density is the one DEXA scan insurance routinely pays for. The paperwork matters, though:
- With a physician's order: private insurance typically covers a medically indicated bone density DEXA, and Medicare Part B covers a bone mass measurement every 24 months (more often when medically necessary) for people who meet its criteria. Your doctor's office handles the order; you pay any applicable deductible or coinsurance.
- Self-pay, no referral: many independent DEXA clinics will run a bone density scan without an order. Cash prices generally fall in the $99–$250 range, well under the $300+ a hospital imaging department charges for the same test, and most clinics accept HSA/FSA payments. You take the report to your doctor to interpret.
Each clinic sets its own price, so confirm the exact amount when you book. If insurance coverage matters to you, start with your physician rather than booking directly.
How to Prepare for a Bone Density Test
- Stop calcium supplements 24 hours before the test. Undissolved tablets can read as bone.
- Wear comfortable clothing without metal: no zippers, belts, buttons, or underwire.
- Bring a list of your current medications and any prior bone density reports so results can be compared.
- No fasting or special diet is required.
- Had a recent barium study or contrast injection? Mention it when booking, because you may need to wait a few days.
- Tell the technologist if you are or might be pregnant.
The appointment itself runs 20–30 minutes door to door. The scan is the easy part.
Find a Bone Density Test Near Me
Dexascans.com lists independent DEXA clinics across the country. In each city below, we've verified by research that at least one listed clinic runs bone density scans. Each link jumps straight to that city's bone density section.
Not listed? Many more of our partner clinics nationwide run bone density scans on the same machines they use for body composition. Browse your state and call the clinic to confirm, or use the location finder:
Find a Location & Book (opens in a new tab)Bone Density vs Body Composition DEXA
Both scans run on the same DEXA machine, but they answer different questions. A bone density test scans your hip and spine and reports T-scores for osteoporosis screening. That's the medical scan insurance covers with a physician's order. A body composition scan images your whole body and reports body fat percentage, lean muscle by region, and visceral fat. That one you book yourself and pay cash for, with no referral involved.
Many clinics offer both in a single appointment, which is the efficient choice if you want the full picture. New to DEXA entirely? Start with what a DEXA scan is and how it works.
Medically reviewed by Dr. Emily Chen, MD, FACP
Bone Density Test: FAQ
What is a bone density test?
A bone density test, also called a DEXA scan, DXA scan, or bone densitometry, is a low-dose X-ray that measures the mineral content of your bones, usually at the hip and spine. It is the gold-standard test for diagnosing osteoporosis and estimating fracture risk before a bone ever breaks. The scan takes about 10–15 minutes, you stay fully clothed, and the result is reported as a T-score comparing your bone density to that of a healthy young adult.
Does Medicare or insurance cover a bone density test?
Usually, yes, when it's medically indicated. Medicare Part B covers a bone mass measurement once every 24 months (more often when medically necessary) for people who meet criteria such as being a woman determined to be estrogen-deficient and at risk for osteoporosis. Private insurance typically covers bone density DEXA scans ordered by a physician for osteoporosis screening or monitoring. Booked without a doctor's order, the scan is self-pay. Many imaging centers and DEXA clinics offer a cash price, and HSA/FSA cards are widely accepted.
Do I need a doctor's referral for a bone density test?
It depends on how you want to pay and where you go. For insurance or Medicare to cover the test, you'll generally need a physician's order. Many cash-pay DEXA clinics, though, will run a bone density scan without a referral: you book directly, pay out of pocket, and bring the results to your doctor to interpret. Hospital imaging departments more often require an order either way, so call ahead.
What do my T-score results mean?
Your T-score compares your bone mineral density to the average peak bone mass of a healthy young adult. By World Health Organization criteria: a T-score of -1.0 or above is normal; between -1.0 and -2.5 is osteopenia (low bone mass); and -2.5 or below is osteoporosis. The Z-score on the same report compares you to people your own age and sex instead, which is the more relevant number for younger adults. Always review your scores with a physician — treatment decisions depend on your full fracture-risk picture, not the T-score alone.
Who should get a bone density test?
The U.S. Preventive Services Task Force recommends osteoporosis screening for all women 65 and older, and for postmenopausal women under 65 who are at increased risk (based on factors like low body weight, smoking, prior fracture, or parental hip fracture). Many clinicians also order the test for men over 70 or anyone with risk factors such as long-term steroid use, a fragility fracture after 50, or conditions and medications known to thin bone. If any of those apply to you, it's worth raising with your doctor.
How much does a bone density test cost without insurance?
Cash-pay bone density DEXA scans at independent clinics typically run in the same $99–$250 range as other DEXA scans, while hospital imaging departments often charge $300 or more for the same test. Each clinic sets its own price, so confirm the exact amount when you book. Most clinics accept HSA/FSA payments for self-pay scans.
Is a bone density scan safe? How much radiation is involved?
Yes. DEXA uses a very low radiation dose, roughly a tenth of a chest X-ray and less than a day of natural background radiation, which is why it's considered safe to repeat every year or two for monitoring. The main exception is pregnancy: tell the technologist if you are or might be pregnant.
How often should I repeat a bone density test?
For monitoring, every 1–2 years is typical. Bone density changes slowly enough that more frequent scans rarely show anything new, and Medicare's standard coverage interval is every 24 months. If you're on active osteoporosis treatment, your physician may order follow-up scans on a specific schedule to track response. Repeat scans are most comparable when done on the same machine.
How should I prepare for a bone density test?
Stop taking calcium supplements 24 hours before the test, wear comfortable clothing without metal zippers, buttons, or underwire, and bring a list of your current medications plus any prior bone density reports for comparison. No fasting or special diet is required. If you've recently had a barium study or contrast injection, mention it when booking, because you may need to wait a few days before the scan.
Is a bone density DEXA the same scan as a body composition DEXA?
Same machine, different scan protocol and report. A bone density test scans the hip and spine and reports T-scores and Z-scores for osteoporosis screening; a body composition scan images the whole body and reports body fat percentage, lean muscle mass, and visceral fat. Many clinics run both — some offer them together in one appointment — but insurance treats them very differently: bone density is often covered with a physician's order, while body composition is almost always cash-pay.
Medical Disclaimer: The information provided on this website is for general informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. DEXA scan results should be interpreted by a qualified healthcare professional.