How Much Does an Ultrasound Cost? (+ Tips to Minimize Your Out-of-Pocket Cost)
An ultrasound is an imaging technique to capture live images from inside your body using high-frequency sound waves. Medical professionals use this procedure to monitor fetal development during pregnancies. It also has many other diagnostic and therapeutic applications.
Once your doctor recommends an ultrasound, the next step is to find a suitable service provider and get it done at an affordable cost. Let’s discuss the cost of an ultrasound, factors that influence the cost, types of insurance plans that have an impact on the cost, and how to save money on your next ultrasound.
How Much Does an Ultrasound Cost?
The cost of different types of ultrasounds varies greatly. You can end up paying less than $50 to more than $2,000, depending on your insurance plan and your healthcare provider. Below, you’ll find a chart with price ranges for uninsured patients based on service providers in California.
|CPT Code||Type of Ultrasound Procedure||Procedure Cost for Uninsured Patients||Total Costs can add up to||Medicare Reimbursement (For Insured Patients)|
|76856||Pelvic ultrasound (not related to pregnancy)||($57-$176)||($580-$1246)||$125|
|76811||Level 2 ultrasound (anatomy scan)||($109-$284)||($406-$873)||$202|
|76870||Testicular ultrasound (scrotal ultrasound)||($140-$280)||($400-$900)||$120|
|76705||Liver and/or gallbladder ultrasound||($45-$163)||($572-$1306)||$103|
|76881||Leg or arm (includes shoulder) ultrasound||($48-$102)||($591-$1207)||$101|
|76536||Neck or head (includes thyroid) ultrasound||($42-$91)||($418-$863)||$132|
|76801||Private pregnancy scan||($83-$160)||($562-$1207)||$138|
|76770||Renal (kidney)||($99-$140)||($494 to $1,143)||$128|
Here’s a quick explanation of some of the information presented in the table:
- CPT codes are codes created by the American Medical Association (AMA). Each code refers to a unique medical procedure. Healthcare providers use these codes for invoicing and billing.
- The column titled ‘Medicare reimbursement (for insured patients)’ can give you a pretty good idea of what the procedure costs. Medicare is federal health insurance for people with permanent loss of kidney function, people with disabilities, and senior citizens. The amount Medicare reimburses for a procedure shows you the price tag the government has placed on that procedure.
Note that the numbers listed above are only a partial estimate. The total cost can add up quickly after including other charges by the surgical center, outpatient facility, or the hospital where you have the procedure done.
Where Should I Get My Ultrasound Done if I am Paying Out of Pocket?
When paying out of pocket, you want to save as much money as possible. There are many medical facilities out there that offer ultrasounds. Some facilities, such as hospitals, will cost you a lot more than other facilities, like imaging centers. Also, some facilities can only do specific types of ultrasounds. For example, at Planned Parenthood, you can only get pregnancy scans, and at dialysis centers, you can only get renal ultrasounds. The following are some options to get diagnostic ultrasounds done at affordable costs.
Outpatient Surgical Facilities
Outpatient surgical facilities are medical facilities owned and operated by a hospital. They are mostly located in the vicinity of the hospital that owns them. The out-of-pocket cost of going to an outpatient facility is lower than a hospital because hospital bills also include facility-based fees along with the cost of the procedure. So if this is an out-of-pocket expense for you, and you have to choose between a hospital and an outpatient surgical facility for your next ultrasound, you might be better off at the outpatient facility.
Ambulatory Surgical Centers
Ambulatory surgical centers are stand-alone facilities where you can walk in, go through a diagnostic or surgical procedure, and go home the same day. You can save a lot of money by going to an ambulatory surgical center as opposed to an outpatient surgical facility. When it comes to ultrasounds, you’ll most likely save a lot more money at a suitable ambulatory surgical center over a hospital or an outpatient facility.
Private Practices and Medical Offices
Private practices are very similar to outpatient facilities in how they function — the difference is that they are owned by private practitioners. Sometimes privately owned clinics offer discounts and promotions, especially on 3D and 4D ultrasounds. It would be a good idea to call multiple clinics and inquire about the price ahead of time before going to a private practice for your ultrasound.
Diagnostic Imaging Centers
Imaging centers specialize in performing all types of diagnostic imaging procedures such as ultrasounds, x-rays, MRIs, CT scans, and more. In most cases, they do not provide any other services, so there are no additional costs to consider when getting your ultrasound done at an imaging center. If you have the option to go to an imaging center for your ultrasound, you may be able to save quite a bit of money over other options on this list.
Hospitals are a costly option if you just want to get your ultrasound done and nothing else. However, in the case of a high-risk pregnancy, it is best that you get the procedure done in a hospital where immediate medical help is available. If it’s nothing serious, you’ll most likely be able to save some money by avoiding the hospital and finding an imaging center for your ultrasound instead.
Most dialysis centers — which mainly focus on kidney dialysis — offer renal ultrasounds as an additional service. As mentioned earlier, the total cost of a renal ultrasound can go over $1,000. If you want to save money on a renal ultrasound, it would be a good idea to call your nearest dialysis center and inquire about the cost.
You can go to your nearest Planned Parenthood to get a low-cost or free ultrasound. This is only applicable for pregnancy-related ultrasounds.
How Much of the Ultrasound Will My Insurance Cover?
Your insurance may cover all or part of the total costs of your ultrasound, depending on multiple factors. For example, if you have an HMO insurance plan and have met your deductible, your plan may cover 100% of the cost. If you have a 20% coinsurance, you will have to pay 20% out of pocket, and the insurance will cover the rest. If you are covered for pregnancy, your ultrasound will be free.
The amount of money you have to pay out of pocket for your ultrasound and the amount your insurance provider will cover depends on multiple factors such as your premium, deductible, and type of insurance plan. Let’s quickly go over some of these concepts:
Your annual deductible is the amount of money you pay out of pocket before your insurance plan kicks in and starts to pay. For example, if your deductible is $900, you will have to pay up to $900 out of pocket for your medical treatment before your insurance plan contributes. If you get your ultrasound done before meeting your deductible, you will have to pay for the ultrasound out of pocket.
A copay is a fixed amount you must pay out of pocket for certain healthcare services, even after you meet your deductible. For some procedures you have a $0 copay, which means you don’t have to pay anything. The information is stated in your contract with your health insurance provider. The amount varies based on the type of medical procedure, and it is determined at the beginning of the relationship between you and your insurance provider. Your copay does not go towards your deductible. For example, if the copay on your renal ultrasound is $50 and you’ve met your deductible, you will have to pay $50 out of pocket, and the rest will be covered by the insurance provider. If you have questions about your copay, it’s a good idea to call your insurance company’s customer service.
Coinsurance is a fixed percentage of the total costs you must pay out of pocket after reaching your deductible. For example, if your coinsurance is 40% and the total cost of your liver ultrasound was $800, you will have to pay $320 out of pocket, and your insurance provider will pay the rest.
Your premium is the monthly amount you pay to the insurance company. You continue to pay this to keep your insurance plan active. Usually, a higher premium means better coverage.
Now that we have discussed different terms related to insurance, let’s talk about different types of insurance plans:
High Deductible Health Plan (HDHP)
Any plan with a deductible of at least $1,400 is considered a high deductible health plan. With a HDHP, you pay a lower premium but have a higher deductible — this means you have to pay at least $1,400 out of pocket before the insurance plan kicks in.
Low Deductible High Premium Plan (LDHP)
Any plan with less than a $1400 deductible for an individual and less than $2800 deductible for a family is a low deductible plan. If you have an LDHP, you pay a higher premium every month and have a lower deductible, so your insurance plan kicks in sooner.
Preferred Provider Organization (PPO)
With this health plan, you get a list of in-network healthcare providers — using their services costs you less than using the services of ‘out-of-network’ healthcare providers. A PPO might be suitable for you if you only prefer to visit particular healthcare providers in your area but want the cushion to visit out-of-network providers as well.
Point of Service (POS)
This is similar to the PPO plan, but the list of in-network service providers you get is shorter. And, because you are limiting your options, the cost is lower.
Exclusive Provider Organization (EPO)
With an EPO, you can only use the services of in-network healthcare providers except for emergencies — otherwise, you’ll have to pay out of pocket. This type of plan might be suitable for you if you only prefer to visit particular healthcare providers and do not plan on using anyone else’s services except in case of emergencies.
Health Maintenance Organization (HMO)
An HMO insurance plan will limit your coverage to doctors in your area (where you live or work) — think of it as an even more limiting version of EPO insurance plans. This can be good for you if you exclusively visit your nearest healthcare service provider.
Ask your health insurance company if the insurance plan covers pregnancy-related ultrasounds. Such ultrasounds are covered in most plans.
How to Save Money on Your Next Ultrasound
- Go to imaging centers when possible — When paying out of pocket, imaging centers usually end up being the cheapest option. If you have insurance, make sure you go to an in-network facility.
- Upgrade your insurance plan, if possible — If you suspect that you will have to go through multiple ultrasounds and similar medical procedures in the near future, it is time to choose a better plan with a bigger network and lower deductible.
- Contact your local clinics to ask about price — Call your local clinics and inquire about their prices—they may even offer you a discount.
- Ask if paying cash will get you a discount — Some imaging centers offer big discounts to patients that pay in cash because it saves them the trouble of chasing after insurance companies.
Compare Ultrasound Costs and Save with Compare.com
Compare.com collects pricing data from all types of medical service providers and helps you find the best options for your next ultrasound. Simply enter the type of ultrasound procedure and your zip code to start comparing healthcare providers in your area.