OBJECTIVES:  To evaluate the impact of the type of payer on health care utilization and the costs of patients treated for breast cancer at a tertiary hospital in India. METHODS:  This study was a retrospective review of electronic medical records from a tertiary care hospital in Mumbai, India. Patients ≥18 years of age hospitalized for breast cancer treatment between Jan 2014 and May 2015 were identified and included in the study. Descriptive and inferential statistics were used to analyze and compare differences between patients. Regression models were also used to determine predictors of total costs for all patients. RESULTS:  A total of 146 patients met the study criteria. The mean length of stay (LOS) for all patients was 5.3+2.5 days. The mean LOS was highest for RGJAY scheme patients and lowest for patients with no insurance (NI). (RGJAY=6.4+1.8 days, private insurance (PI) =4.3+3.5, CGHS=3.5+2.28, NI=2.6+1.8; p<0.001). Patients with NI went into surgery the earliest (1.2+0.6 days) while CGHS patients were discharged from the hospital the earliest (2.6+1.3 days). Patients with PI received the highest number of per patient clinician visits compared to other patients (PI=16.3 visits/patient, NI=11.8, CGHS=2.7, RGJAY scheme=2.2; p<0.001). Patients with NI (unit doses=3435) and PI (unit doses=1863) received the highest unit doses of drug while RGJAY scheme patients (unit doses=649) received the least. Mean hospital costs were highest for patients with PI and lowest for RGJAY scheme patients (PI=$2381.03+1739.31, NI=$1558.70+1342.56, CGHS=$723.19+731.57, RGJAY=$637.41+118.20,). Clinician visits (r=0.576, p<0.01) and having PI (r=0.334, p<0.01) were found to be significant predictors of costs in the regression model. CONCLUSIONS:  Significant differences were found in resource utilization and costs among breast cancer patients. Patients covered by private insurance and no insurance incurred higher costs but received more resources, which could lead to better care, compared to patients with other insurances.