An abdominal aortic aneurysm (AAA) screening is a simple ultrasound that typically costs between $100 and $300 out of pocket if you’re paying without insurance. However, most people who qualify for this screening pay nothing, because Medicare and private insurance plans cover it at no cost for eligible individuals.
What the Screening Costs With Insurance
If you have Medicare Part B and meet the eligibility criteria, the screening is covered at 100% of the Medicare-approved amount. You pay no deductible and no coinsurance, as long as your provider accepts Medicare assignment. Medicare Advantage plans follow the same rule: no deductibles, copayments, or coinsurance when you see an in-network provider.
Private insurance plans sold through the ACA Marketplace (and most employer-sponsored plans) also cover AAA screening with zero cost-sharing for men of specified ages who have ever smoked. This falls under the Affordable Care Act’s required preventive services, meaning no copay and no coinsurance even if you haven’t met your yearly deductible.
There’s an important catch. Both Medicare and most private plans cover this screening only once in your lifetime. If your doctor later recommends a second ultrasound to monitor your aorta, that follow-up scan is considered diagnostic, not preventive, and your normal cost-sharing (deductibles and coinsurance) will apply.
What It Costs Without Insurance
Without insurance, you’ll typically pay somewhere between $100 and $300 for the ultrasound itself. The total depends heavily on where you get it done. National Medicare averages for abdominal imaging illustrate the gap: a hospital outpatient department charges roughly $656 total (combining a $300 doctor fee and a $356 facility fee), while an ambulatory surgical center or independent imaging facility charges around $492 for the same service ($300 doctor fee, $192 facility fee). That facility fee alone nearly doubles at a hospital compared to a standalone center.
If you’re paying out of pocket, calling ahead to compare prices at independent ultrasound or imaging centers in your area can save you hundreds of dollars. Many facilities offer a cash-pay or self-pay discount if you ask.
Who Qualifies for Free Screening
Medicare and most insurers use the same risk-based criteria to determine who gets the screening covered at no cost. You qualify if you fall into at least one of these categories:
- Men aged 65 to 75 who have smoked: This means having smoked at least 100 cigarettes in your lifetime, even if you quit decades ago.
- Anyone with a family history: If a parent or sibling had an abdominal aortic aneurysm, you’re considered at risk regardless of sex or smoking history.
- Other risk categories: The U.S. Preventive Services Task Force periodically updates its recommendations, and additional groups may qualify based on those guidelines.
You also need a referral from your doctor, physician assistant, or nurse practitioner. The screening won’t be covered if you simply walk into an imaging center and request one on your own.
What Happens During the Screening
The screening itself is a standard abdominal ultrasound. A technician applies gel to your abdomen and uses a handheld probe to capture images of your aorta, the large blood vessel running through your midsection. There are no needles, no radiation, and no pain. The whole process takes about 30 minutes.
You’ll likely be asked to fast for 8 to 12 hours beforehand. Eating before the exam can cause gas buildup in your abdomen, which interferes with the ultrasound image quality. Most people schedule a morning appointment and skip breakfast.
When a Screening Becomes Diagnostic
This is where unexpected costs can appear. If the technician or radiologist spots something during your screening, whether it’s an aneurysm, a kidney issue, or anything else that needs further investigation, the visit can shift from “preventive” to “diagnostic.” Once that happens, standard insurance cost-sharing kicks in. You could owe a copay, coinsurance, or charges toward your deductible for any additional imaging or evaluation performed during that same visit.
Similarly, if you’ve already used your one-time screening benefit and your doctor orders another ultrasound to monitor a known small aneurysm, Medicare and most insurers will process it as a diagnostic test. In that case, you’d be responsible for your usual share of costs. For Medicare beneficiaries, that means the Part B deductible plus 20% coinsurance on the Medicare-approved amount. For private insurance, it depends on your plan’s terms for diagnostic imaging.
If you’re unsure whether a recommended ultrasound will be billed as screening or diagnostic, ask your doctor’s billing office before the appointment. The distinction between these two billing categories is the single biggest factor in whether you’ll owe anything.