What to Expect: Ultrasound Costs
Of the many financial matters you need to prepare when you're getting ready to welcome a new baby, healthcare costs are at the top of the list—from prenatal care to hospital delivery costs, the amounts will likely add up, whether you have insurance or not. Ultrasounds are a common and often necessary part of prenatal healthcare—however, costs and coverage can vary depending on a variety of factors, such as where you live, where you get care, and your health plan.
Here is what you need to know about the average cost of ultrasounds and what insurance does (and doesn't) cover, along with some affordable options.
How much does an ultrasound cost?
Healthcare Bluebook, a fair pricing resource for medical procedures, says a reasonable cost for a fetal ultrasound is about $200, with the number dropping below that in some states. However, the price can vary a lot depending on where you live and where you seek care. For example, healthcare price comparison site New Choice Health reports the average cost of a fetal ultrasound only costs $134 in Tampa, Florida—while the average in Baltimore, Maryland is $648.
Ultimately, ultrasounds can range anywhere from $200 to $800 or more, and can easily cost over $1,000 if you go to an out-of-network provider. Typically, large hospitals with higher administrative costs charge more for ultrasounds than a doctor's office or a stand-alone clinic.
Are ultrasounds covered by insurance?
While the Affordable Care Act requires most prenatal checkups and treatments (such as screening for gestational diabetes or preeclampsia) to be covered by all Marketplace health care plans and many other plans, ultrasounds are not specifically stated—unless they are medically required by your doctor. To be sure, check with your insurance to find out whether pregnancy ultrasounds are covered in your policy.
A sonogram of your fetus to find out the sex, or even 3D images might sound like a precious memory to cherish, but you will have to pay out-of-pocket for any ultrasounds that are not prescribed by your doctor—and it's not recommended either. The FDA and American Institute of Ultrasound in Medicine (AIUM) have released statements saying keepsake ultrasounds might not be the safest, and that ultrasounds should only be performed when prescribed by a doctor and performed by trained professionals such as obstetricians, radiologists, or sonographers.
If you are prescribed an ultrasound by your doctor and have insurance, make sure you stay within your network so you have the least out-of-pocket costs and the procedure can be partially or fully (if you have met your deductible) covered by your plan.
"Out-of-network fees are significantly higher and often require patients to pay the full cost," says Hutch Ashoo, founder and CEO of Pillar Wealth Management.
What are some options for affordable ultrasounds?
If you don't have insurance, ultrasound costs can be hefty. "Mostly, the price of ultrasound depends on the state," Alex Williams, a certified financial planner, tells Parents. "Every state has different prices for doctor-prescribed sonograms," he explains.
So avoid any elective ultrasounds if you don't have insurance, to minimize your costs. If your physician prescribes an ultrasound for you, smaller clinics are likely to provide you with more low-cost services: "Most stand-alone facilities charge between $150 to $400 for an ultrasound, while big hospitals can charge as much as $1000," says Christopher Morgan, personal finance expert.
You can also talk to the provider to see if you are able to set up a payment plan for the ultrasound. Another option is to visit your local Planned Parenthood clinic for free or low-cost ultrasounds if you don't have insurance.