Is My Ultrasound Covered By Insurance?
What is an ultrasound?
An ultrasound — also known as a sonogram — is an imaging scan that uses high-frequency sound waves to create internal images of the body and, for pregnant people, the fetus inside it. Ultrasounds are often done transvaginally or over the abdomen to visualize the fetus, the placenta, and the amniotic fluid.
Employing high-frequency sound waves, ultrasounds produce images of your fetus and internal organs (like your uterus and cervix). There are two types of ultrasounds — through the skin on your abdomen (belly), or through the inside of your vagina for those assigned females at birth. Ultrasounds are also commonly used in diagnostic imaging to provide vital health information about the body’s soft tissue and internal structures.
During an abdominal ultrasound, the medical technician squirts gel on your stomach, places the wand against the skin, and moves it around to capture the needed images. The gel can be cold, and patients sometimes feel mild pressure on their stomach from the wand, but the procedure is not invasive or painful.
Will insurance cover an ultrasound?
Ultrasounds are the second most frequently prescribed medical imaging procedure, behind only X-rays, but only a small fraction of ultrasounds and other pregnancy-related health-care costs are completely covered by insurance companies. Patients with health insurance in California hospitals can expect to pay a copay between $34 and $378, which is 25% of the total cost of the ultrasound procedure. Prices range depending on where the ultrasound is performed.
To avoid additional charges, ensure the radiologist is also in-network; otherwise, you will have to pay their full fee, not to mention those with large deductibles. Patients who haven’t met their yearly deductible will likely be billed the full procedure list price ($138 – $1,514) because their insurance coverage will kick in only after meeting the yearly deductible.
Almost 40% of all adult patients have high-deductible insurance plans, which means they need to meet their deductible of up to $13,000 per family before their insurance kicks in. These patients can expect to pay the full price for the ultrasound ($138 – $1,514). For them, the best option is often to pay in cash.
By forgoing insurance, self-pay patients can get up to an 80% discount on their medical imaging scans. While many imaging centers offer cash pay discounts, it is best to contact them directly to make sure. Even then, there is no set guide to how much they will cost since pricing information is not often advertised and can vary based on many factors. Fortunately, Medmo takes the guesswork out of finding the best price for imaging scans. We match patients with centers that offer the most affordable rates for medical imaging at locations near them.
To book a scan, visit us at Medmo.com. Medmo helps people schedule radiology imaging tests – such as MRI, CT scans, PET, and more – at nearby accredited centers and identify the payment solution that works best for them.
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Here’s what you’ll need to schedule an appointment
1. Imaging referral / prescription
2. Your contact information
3. Insurance OR card information