A Papanicolaou test — commonly referred to as a Pap smear or Pap test — is a routine procedure at most gynecological exams. The pap smear is a laboratory test carried out to determine if you have abnormal cervical cells. Abnormal cervical cells can indicate cervical cancer.
As with most health procedures, the cost varies, but a Pap smear will typically run you $50 to $150 without insurance in the United States. With insurance, Pap smears are usually covered. These estimates don’t include the cost of a full pelvic exam, during which a Pap smear is usually performed. And there are health clinics where these health services can be covered without cost to patients.
Medicare and Medicaid may also cover Pap smears. Check with your provider to see if your plan covers them.
The only additional cost associated with a Pap smear is that the lab might bill you separately. They may perform tests that your insurance does not cover.
Doctors recommend avoiding sex (penetrative and oral) for up to 48 hours before your test and avoiding any gels or creams that go around or inside the vagina, but that’s about it. You don’t need to do much of anything to prepare for a Pap smear. Also do your best to stay calm when it comes time to start the procedure — Pap smears tend to go more smoothly if you’re relaxed.
At your appointment, you will be asked to put on a gown and remove your undergarments. You will lie down with your bottom on the edge of the examination table. The healthcare professional will guide your feet and legs onto the stirrups to support you.
They will insert a speculum covered in lubricant into your vagina. They will then use a small brush or swab and gently wipe the inside of your cervix to collect a small sample of cells. (The scraping for cells will only last a few seconds.) Those cells are then sent to a laboratory to be tested for irregularities.
If your cells require further study, your healthcare professional may recommend a procedure called a colposcopy, which uses light and magnification to get a closer look at your cervical tissue.
The most important thing to remember, however, is that a pap smear may be uncomfortable but shouldn’t be painful. If you feel pain, let your healthcare professional know.
If you already see an OB-GYN, they likely can perform this test for you. If for some reason they cannot or you don’t have an OB-GYN, ask your primary care doctor for a recommendation of a practitioner in your area.
Remember that some communities may have medical facilities that provide pap smears at a lower cost or at no cost. The Centers for Disease Control and Prevention (CDC)
Anyone with a cervix should get a pap smear, but
| 21–29 years old | In this age range, you should get your first Pap smear. |
| 30–65 years old | Starting at age 30, you should aim to get a Pap test every 3 years. At this time, you may also choose to combine your Pap test with an HPV test; HPV (human papilloma virus) is a virus that can cause cervical cancer. |
| 65 or older | You may not need to be screened anymore if your Pap smears have been normal for many years or if your cervix has been removed. Ask your healthcare professional for advice on if you should continue to receive Pap smears. |
Those who have had a hysterectomy that included removal of the cervix and no history of cervical cancer do not need screening. However, no matter what age you are, you should still try to see your OB-GYN once a year.
If your results are clear, or “negative,” there’s no need to do anything. Some doctors take the “no news is good news” approach. So if you don’t hear back from your doctor’s office or the lab, there’s likely no need to worry. However, it’s recommended to continue getting Pap tests at the recommended intervals above.
If your result is positive, that means the doctor found some type of irregularity. But don’t panic! Abnormal cells could indicate the presence of HPV — which is common and often goes away on its own.
If your test is positive, your healthcare professional may recommend a second test or an HPV test. If the “positive” result is confirmed after a second test or the HPV test comes back positive, your doctor will recommend further action based on your specific needs.
You may also get an “unclear” or “inconclusive” result, which may require further testing.
The cost of a Pap smear varies but not too much. All in all, it should cost less than $100 with insurance in the United States.
If you’re paying out of pocket, expect the costs to range from $25 to $150. And don’t forget there may be medical facilities in your area that offer Pap smears at a lower cost or at no cost.
Jody Amable is a freelance writer and editor from the San Francisco Bay Area specializing in music and subcultures. Her work has been seen in KQED Arts, Atlas Obscura, and local weeklies.