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Feb 11

Paying out of pocket for your Ultrasound Exam?

You don’t need a doctor’s order to have an ultrasound performed and interpreted. Cash pay discounts.

Ultrasound Cost Summary & Tips

  1. Not all ultrasound procedures will be paid for by your insurance carrier so it’s important to know what you are being charged for each and every procedure. If you will be responsible for paying the bill and covering your own cost make sure you ask your doctor or obstetrician, midwife, or other healthcare professional for names of other licensed sonographers they would recommend.
  2. Shop around for the best possible Ultrasound procedure cost. Doing your research can save you up to a hundred or more dollars on your bill.
  3. Stand-alone ultrasound facilities are often cheaper than hospitals and are often more open to negotiate what they charge for an ultrasound.
  4. If you are paying up front – ask what the facilities best rate is for an ultrasound and make sure you tell them that you will be paying with cash or credit. This alone may save you money in that an ultrasound facilities “best rate” is often much less than the facility’s published charge.

What does an Ultrasound cost?

Where you have your Ultrasound performed, how much you are charged, and how much you have to pay is up to you and where you get your ultrasound. By doing a little homework and shopping around you can save hundreds of dollars. An ultrasounds performed by a licensed medical professional (physician or registered diagnostic sonographer) costs on average between $100 – $1,000 depending upon what type of ultrasound you get (3-D vs. regular). Not all facilities charge the same amount for the same procedure. Usually stand-alone ultrasound facilities, which are not associated with hospitals, cost around $99 to $300. The same ultrasound performed at a hospital may run $200 to $1000. These ultrasound cost usually include the price for black and white pictures, videos, and/or a CD photo disk. Often the cost of an ultrasound is reimbursed by insurance companies if the procedure is considered medically necessary. If this is the case then usually small co-pay is the only out of pocket expense. However, if you are getting an ultrasound simply to have a picture (3-D, 4-D, or standard 2-D) your insurance company may not be willing to pay the cost of the procedure and you will be left responsible for the charges. So make sure you ask your insurer if the intended ultrasound will be reimbursed or not. If the cost will not be reimbursed then make sure you shop around for the procedure to ensure you save as much as you possibly can.

Cancellation Policies

Most doctors’ offices and imaging center will not charge a cancellation fee if you miss your appointment. If you are getting one of the higher priced ultrasounds, like a 3-D or 4-D, you may want to call before you decide to not show up for your appointment because they may have a nominal fee for canceling 24 hours prior to your appointment. Insurance will not pay for any cancellation fees so make sure that you try to call at least 24 hours in advance if you are unable to show up to a scheduled appointment.

Payment Methods

In addition to accepting typical medical insurance reimbursement, most all hospitals and imaging centers accept the following payment methods; cash, check, MasterCard, Visa, Discover, and American Express credit cards. Most all testing facilities require any out-of-pocket deductible or co-payment be paid upon office visit. For uninsured customers, most testing facilities offer a discount when the full discounted amount is paid by cash or credit within 60 days of the procedure.

Costs Reimbursement – Insured Customers

Most insurance companies, including Medicare, will reimburse the cost of getting an ultrasound. In most situations when an ultrasound is requested by a medical professional the procedure is automatically determined to be reimbursable dependent upon your particular insurance plan. It’s important that you are familiar with your insurance prior to having any procedure, especially expensive procedures, performed to know if there are any special notifications or authorizations that need to be secured to ensure reimbursement. Make sure you notify the imaging doctor or technician of your concerns or pre-certification prior to any elective tests or procedures. If pre-certification is required by our insurance carrier and you do not get such pre-certification this may result in full denial of your insurance claim. Medicare and other insurance coverage policies are always changing so it is important that you contact Medicare (www.mericare.gov) or your insurance company to determine coverage prior to having any procedure performed.

Costs Reimbursement – Uninsured Customers

If you do not have insurance you may qualify for a discount if the discounted balance of the procedure cost is paid in full within 60 days of the procedure. Most facilities accept cash, cashier’s checks, and Visa, MasterCard, and American Express credit cards. Depending on your financial status and specific situation, a greater discount or charity may apply. In addition there may be other alternatives to working with the imaging centers for payment and/or procedure cost reimbursement.

Costs Reimbursement – Other Alternatives & Options

If your financial situation presents a challenge for making full payment for an ultrasound procedure make sure you ask for assistance. Be honest and up front about your situation and work with the hospital or imaging center to determine the various alternatives to reducing the cost of the ultrasound or spreading out the cost to make it easier to manage with your current cash flow. Some possible payment options include:

Payment Plans: Hospitals and imaging centers often do not accept payment plans, but exceptions are often made in extreme financial hardship cases. So if the cost of an ultrasound puts you in a financially vulnerable position do not hesitate to ask for some type of payment plan.

Charity Care Qualifications: If your family income and assets are within 200% of Federal Poverty Guidelines, financial assistance may be provided. Imaging centers and hospitals often consider these on a case-by-case basis. If you meet the initial screening criteria the facility may need to review your federal income tax returns, current pay stubs, and/or denial of third party benefits.

Employees Group Benefit Program: If you are a participating employee in a Group Benefit Program at work, you and your employer can arrange to have the cost of your ultrasound paid for under the program by your employer’s group insurance carrier on an “extra-contractual” basis. The terms vary from plan to plan, but group benefit programs invariably provide for such “extra-contractual” arrangements. The expense is tax-deductible to the employer so make sure you speak with your employer before you pay for your ultrasound.

Tax Credits: If you do end up having to pay for the cost of an ultrasound you may be eligible for a medical tax credit. Make sure you keep your paperwork and receipt and speak with an accountant. This may be very helpful for people who are retired and may save you hundreds of dollars in taxes.

Types of Ultrasound

A Doppler ultrasound study may be part of an ultrasound examination. Doppler ultrasound is a special ultrasound technique that evaluates blood as it flows through a blood vessel, including the body’s major arteries and veins in the abdomen, arms, legs and neck. There are three types of Doppler ultrasound:

  1. Color Doppler uses a computer to convert Doppler measurements into an array of colors to visualize the speed and direction of blood flow through a blood vessel.
  2. Power Doppler is a newer technique that is more sensitive than color Doppler and capable of providing greater detail of blood flow, especially in vessels that are located inside organs. Power Doppler, however, does not help the radiologist determine the direction of flow, which may be important in some situations.
  3. Spectral Doppler. Instead of displaying Doppler measurements visually, Spectral Doppler displays blood flow measurements graphically, in terms of the distance traveled per unit of time.

How does an Ultrasound work?

In medicine, ultrasound is used to detect changes in appearance and function of organs, tissues, or abnormal masses, such as tumors. In an ultrasound examination, a transducer both sends the sound waves and records the echoing waves. When the transducer is pressed against the skin, it directs a stream of inaudible, high-frequency sound waves into the body. As the sound waves bounce off of internal organs, fluids and tissues, the sensitive microphone in the transducer records tiny changes in the sound’s pitch and direction. These signature waves are instantly measured and displayed by a computer, which in turn creates a real-time picture on the monitor. These live images are usually recorded on videotape and one or more frames of the moving pictures are typically captured as still images.

Ultrasound imaging is based on the same principles involved in the sonar used by bats, ships and fishermen. When a sound wave strikes an object, it bounces backward, or echoes. By measuring these echo waves it is possible to determine how far away the object is and its size, shape, consistency (whether the object is solid, filled with fluid or both) and uniformity.

Doppler ultrasound, a special application of ultrasound, measures the direction and speed of blood cells as they move through vessels. The movement of blood cells causes a change in pitch of the reflected sound waves (Doppler Effect). A computer collects and processes the sounds and creates graphs or pictures that represent the flow of blood through the blood vessels.

Smart Health Screening

Ultrasound Laboratories, Inc. dba SmartHealth Screening & SonoTech Imaging. We provide abdominal, cardiac and vascular ultrasound imaging services to physicians offices and patients homes. We accept most insurances including Medicare and Medi-Cal. 1-877-650-0650. Offices with Saturday appointments in Sunnyvale and Mountain View, CA