DEXA Scan (Bone Density Test): Who Needs One, What It Costs, and How to Book

What is a DEXA scan?

DEXA stands for dual-energy X-ray absorptiometry (you may also see it written as DXA or "bone densitometry"). It uses two very low-dose X-ray beams to measure how many minerals — mainly calcium — are packed into your bones. More minerals mean denser, stronger bones.

The scan usually focuses on your hip and lower spine, because those are the most common and serious places for fragility fractures. You simply lie on a padded table while a scanning arm passes over you. There's no tunnel, no injection, and nothing to swallow — you even stay fully clothed. The result is a T-score that compares your bone density to a healthy young adult's; we explain exactly how to read it below.

Why it matters: bones weaken silently. Osteoporosis usually has no symptoms until a bone breaks, and a DEXA scan is the standard way to spot the trend years earlier — when diet, exercise, and (if needed) medication can still change the trajectory.

Who should get a DEXA scan — and how often

The U.S. Preventive Services Task Force (USPSTF) updated its osteoporosis screening recommendation in January 2025. It gives bone density screening a Grade B — the same strength of recommendation behind mammograms — for two groups:

• All women age 65 and older, regardless of other risk factors.
• Postmenopausal women under 65 at increased risk of fracture — for example, a parent who broke a hip, low body weight, current smoking, or early menopause.

For men, the USPSTF found the evidence insufficient to make a blanket call — that's not a "no," it's a "not enough data yet." Many bone-health specialists suggest a DEXA scan for men 70 and older, or earlier with risk factors like long-term steroid use or a prior fracture. If you're unsure where you land, your doctor can run a quick risk assessment (often called a FRAX score) in a few minutes.

How often? For most people, every two years is the typical interval, and it's also how often Medicare covers the test. Your doctor may suggest sooner if you have low bone density or are starting or changing osteoporosis treatment. If your first scan is normal and nothing about your health changes, you may comfortably wait longer between scans.

What a DEXA scan costs — with and without insurance

Here's the part many people are relieved to learn: a screening DEXA scan is usually $0 with insurance when you qualify. Because the USPSTF recommends it as preventive care, the Affordable Care Act requires most insurance plans to cover it with no out-of-pocket cost for eligible patients — such as women 65 and older, or younger postmenopausal women at increased risk.

Medicare Part B covers a bone mass measurement once every 24 months for qualifying beneficiaries, and more often when your doctor documents medical need.

Paying without insurance? Based on the self-pay prices we collect from clinics, a DEXA scan usually runs about $50–$550, with a typical price around $150. Hospital-based scans tend to sit at the top of that range and freestanding imaging centers at the bottom, so it pays to compare. You can explore our DEXA scan cost data, and participating clinics on Expected Health show their price upfront — no surprise bills.

What to expect (and how to prepare)

A bone density scan is one of the easiest tests in all of imaging. You'll lie on your back on a cushioned table while a mechanical arm glides quietly above you — it never touches you. The whole visit typically takes 10 to 20 minutes, and the scan itself is completely painless.

Preparation is simple:

• Wear comfortable, loose clothing with no metal — avoid zippers, belts, buttons, or underwire near your hips and spine. Many centers provide a gown if needed.
• Skip calcium supplements for about 24 hours before your scan, since they can affect the reading. Your regular food is fine — no fasting needed.
• Tell the technologist if you've recently had a barium exam, a CT scan with contrast, or a nuclear medicine test — those may require a short wait first.

One common mix-up: the fasting and no-caffeine rules you may have read about apply to body-composition DEXA scans, not the bone density test. For osteoporosis screening, eat normally. There's nothing to recover from afterward, so you can drive yourself home and get right back to your day.

Understanding your results: T-scores, osteopenia, and osteoporosis

Your results come back as a T-score — a comparison of your bone density to that of a healthy young adult:

• -1.0 and above means normal bone density.
• -1.0 to -2.5 means osteopenia (low bone mass — often managed with diet, exercise, and lifestyle changes).
• -2.5 and below means osteoporosis (bones are fragile and more likely to break).

A lower (more negative) number means weaker bones. Your report may also include a Z-score, which compares you to people your own age and sex — useful context, but the T-score is what drives decisions. Your doctor reads the numbers alongside your age, history, and risk factors, sometimes combining them into a FRAX fracture-risk estimate.

If the scan finds something, it's not an emergency — it's a head start. Osteopenia is usually addressed with calcium, vitamin D, weight-bearing exercise, and a repeat scan in about two years to check the trend. Osteoporosis is very treatable: today's medicines can slow bone loss or actively rebuild bone, and they meaningfully lower fracture risk. Either way, the scan turns an invisible process into a plan.

What you can do for your bones — at any score

Whatever your T-score says, the everyday playbook for bone strength is the same, and it works best when you start early:

• Feed your bones — calcium-rich foods (dairy, leafy greens, fortified foods) plus enough vitamin D to absorb it.
• Load your bones — weight-bearing activity like walking, hiking, or dancing, plus strength training a couple of times a week. Bone responds to being used.
• Protect your bones — if you smoke, quitting helps your skeleton too, and keeping alcohol moderate does the same.
• Prevent the fall, not just the fracture — good lighting, secure rugs, and balance exercises quietly prevent more broken bones than most people realize.

Your follow-up DEXA scans are how you and your doctor see whether the plan is working — one more reason the every-two-years rhythm is worth keeping.

Risks and limitations — the honest picture

Radiation first, because it's the most common worry: a DEXA scan uses one of the smallest doses in medical imaging — about 0.001 to 0.01 mSv, less than a tenth of a standard chest X-ray and roughly the natural background radiation you absorb in a single day of ordinary life.

The test does have limits worth knowing. Arthritis or previous spinal compression fractures can make spine readings look better than your bones really are (which is one reason the hip is measured too). And because different machines calibrate slightly differently, it's best to have repeat scans on the same machine when possible, so your trend over time is a true comparison.

Finally, a word about the osteopenia label: a large share of adults over 50 fall into this range, and it's information, not a disease. It usually calls for lifestyle changes and a follow-up scan — not automatic medication. Sticking to guideline-based screening, rather than testing earlier or more often than recommended, is what keeps the results genuinely useful.

How to book a DEXA scan on Expected Health

1. Search your area — enter your ZIP code to see imaging centers offering DEXA scans near you.
2. Compare and choose — check self-pay prices, hours, and reviews, then pick the clinic that works for you.
3. Book online in minutes — request your appointment without phone calls or waiting on hold.

Most centers ask for a doctor's order (it also helps with insurance coverage), but some offer self-pay scans with no referral needed. Each clinic's page shows exactly what's required, so there are no surprises on scan day.

While you're thinking about screenings: a DEXA often lands on the calendar alongside other tests due at the same stage of life. Women keep up mammograms through at least age 74, and men 65–75 who ever smoked qualify for a one-time abdominal aortic aneurysm ultrasound. When you're ready, find a DEXA scan near you.