Latest research on REMS shows that it is not using much of the ultrasound measurements, 90% just demographic data. I also had self-pay REMS done, but I no longer believe the results.

Demographic determinants of REMS-derived BMD and fragility score
https://link.springer.com/article/10.1007/s00198-026-07960-4
EXCERPT: "Conclusions
REMS-BMD and fragility scores are strongly influenced by demographic inputs, particularly age and weight. The REMS output therefore reflects an assessment of BMD and fracture risk strongly based on demographic parameters, rather than an ultrasound-based direct skeletal measurement. ..."

REMS Bone Scan (Echolight): What the Evidence Says About This DEXA Alternative
https://melioguide.com/osteoporosis-prevention/rems-bone-scan/
EXCERPT: "A 2026 study in Osteoporosis International (Chan et al.) found that age and weight alone explain the vast majority of REMS output variance. The coloured bars show how much of each result is predicted by demographics alone. ..."