Does Health Insurance Cover Ultrasounds?

While ultrasounds may be immediately associated with pregnancy, there are other times when a physician might order this diagnostic test. Whether your health insurance will cover an ultrasound depends on the reason for the procedure and the parameters of your policy.

What Is an Ultrasound?

An ultrasound might also be called a sonogram. The Mayo Clinic explains that this procedure utilizes high-frequency sound waves to make images of areas inside the body. These images are useful for providing doctors with the information needed to make diagnoses. Once a diagnosis is reached, a doctor can then formulate a course of treatment.

Typically, an ultrasound involves applying gel to the skin and then placing a transducer on the outside of the body. The transducer sends sound waves into the body, and then it gathers the sound waves that bounce back. These sound waves go to a computer, which makes images of the inside of the body.

Medical Reasons for Ultrasounds

Ultrasounds can be used for a number of health situations. One of the most common uses of ultrasounds is in conjunction with pregnancies. Ultrasound enables physicians to view the uterus during pregnancy to monitor a baby’s health, states Mayo Clinic.

Ultrasounds are also used to diagnose gallbladder disease, to guide needles during tumor biopsies, to check blood flow, to examine breast lumps and thyroid glands, to diagnose prostate issues, to check for joint inflammation and to monitor metabolic bone diseases, according to Mayo Clinic.

Unnecessary Ultrasounds

Unnecessary ultrasounds are also a common event during pregnancy. These ultrasounds are often called “keepsake ultrasounds,” because they are not medically necessary. Instead, they enable expectant parents to get a glimpse of their unborn babies. These ultrasounds will often reveal fetal gender as well.

Most health insurance plans won’t cover ultrasounds that are not a medical necessity. In these case, you would be responsible for paying out-of-pocket expenses for the ultrasound.

Prices for Ultrasound

The price for an ultrasound depends on several factors. Some providers will offer discounts if you pay in full on the day of service in cash. If you opt to pay in installments, expect to pay more.

The CostHelper website estimates that a typical ultrasound by a licensed medical professional will cost around $200. Keepsake ultrasounds performed at stand-alone facilities that are not associated with a medical facility may range from $100 to $300, depending on the package.

Additional Tips

As long as your ultrasound is necessary and ordered by a physician, it’s likely to be covered. To avoid unexpected expenses with an ultrasound, check your health insurance policy to learn about any limitations regarding ultrasounds.