A hysterosalpingogram (HSG) is a specialized X-ray procedure used to assess the internal structure of the uterus and the patency, or openness, of the fallopian tubes. This diagnostic test is commonly performed during a fertility evaluation to determine if structural issues or blockages are contributing to difficulty conceiving. The procedure involves injecting a contrast dye through the cervix, allowing a radiologist to track the flow using fluoroscopy, a type of continuous X-ray imaging. The financial cost of the procedure is highly inconsistent and depends on a wide range of variables.
The Average Cost of an HSG
The total out-of-pocket cost for an HSG procedure fluctuates dramatically based on whether a patient has insurance and where the test is performed. For individuals paying the cash price without insurance coverage, the expense typically ranges from approximately $400 on the low end to $3,000 or more on the high end.
Lower prices, often between $327 and $810, are commonly seen at independent imaging centers or through healthcare marketplaces offering pre-negotiated rates. Conversely, higher costs are often associated with procedures performed in hospital outpatient departments, which generally carry higher overhead fees. For insured patients, the cost is the patient responsibility, which can range from $0 to over $1,500 depending on the policy specifics.
Factors Influencing the Final Price
The primary determinant of the total list price is the type of facility where the HSG is conducted. Outpatient imaging centers and specialized fertility clinics typically offer lower prices than large hospital systems, which must cover extensive administrative and operational costs. Hospitals often charge a separate, higher facility fee for the use of their equipment and space.
Geographic location is another major variable, as healthcare costs are closely tied to the regional cost of living and local market competition. Procedures performed in large metropolitan areas tend to be more expensive than those in rural regions. Furthermore, the specific expertise of the healthcare provider and the technology used can influence the price.
Understanding Insurance Coverage and Billing
The patient’s financial responsibility is largely determined by the structure of their health insurance plan. Since the HSG is a diagnostic test used to find a cause of infertility, many insurance providers offer at least partial coverage. However, the level of coverage hinges on the patient’s deductible, the amount they must pay out-of-pocket before the insurance plan begins to contribute.
If the patient has not met their annual deductible, they will be responsible for the entire negotiated charge. Once the deductible is met, the patient typically pays a co-payment or co-insurance, which is a percentage of the remaining cost. Many plans also require pre-authorization before the procedure, confirming medical necessity and preventing the patient from being held responsible if the claim is denied. The medical facility will typically use Current Procedural Terminology (CPT) codes to bill the insurer, most commonly using code 58340 for the catheterization and contrast injection and code 74740 for the radiological supervision and image interpretation.
What the Procedure Fee Covers
The total fee for a hysterosalpingogram is a compilation of several distinct services and supplies. A large portion of the cost is the facility fee, which covers the use of the examination room, the specialized X-ray equipment, and the technical staff who assist with the imaging. This fee is separate from the professional fee charged by the radiologist.
The radiologist’s professional fee covers performing the procedure, supervising the dye injection, and interpreting the resulting X-ray images to generate a formal report. The cost also includes necessary medical supplies, such as the specialized catheter and the contrast agent itself. The fee may also cover necessary pre-medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), recommended to manage cramping.