Getting an ultrasound starts with a doctor’s order. In nearly all cases, you need a healthcare provider to determine that the scan is medically necessary before a facility will perform it or insurance will cover it. The process from initial visit to results typically takes anywhere from a few days to a couple of weeks, depending on how quickly you can get appointments.
You’ll Need a Doctor’s Order First
Ultrasound imaging facilities require a referral from a physician or qualified practitioner before performing a scan. This isn’t just a formality. Insurance companies, including Medicare, only cover ultrasounds when a provider documents specific signs, symptoms, or abnormal findings that justify the test. Screening ultrasounds done without any symptoms or medical reason are generally not covered unless a specific law authorizes them.
To get this order, schedule a visit with your primary care doctor or a specialist and describe your symptoms. Common reasons providers order ultrasounds include abdominal pain, a lump or mass, pelvic pain, pregnancy monitoring, thyroid nodules, and unexplained swelling. Your doctor will document the medical reason on the order, which the imaging facility and your insurer both need to process the claim. If you already see a specialist for a related condition, they can typically order the ultrasound directly without routing you back to your primary care provider.
Scheduling and Prior Authorization
Once your doctor writes the order, their office may schedule the ultrasound for you or give you a referral to call an imaging center yourself. Some insurance plans require prior authorization for imaging, meaning your doctor’s office submits the order to your insurer for approval before the scan can be scheduled. This can add a few business days to the timeline, so ask your doctor’s office whether your plan requires it.
You can usually choose where to have the ultrasound done. Hospitals, outpatient imaging centers, and some doctors’ offices all perform ultrasounds. Outpatient imaging centers tend to cost less than hospital-based facilities for the same scan, so it’s worth comparing if cost is a concern.
What Ultrasounds Cost
With insurance, your out-of-pocket cost depends on your plan’s deductible and coinsurance. Medicare, for example, covers diagnostic ultrasounds at 80% of the approved amount after you meet your Part B deductible. Private insurance varies, but most plans cover diagnostic ultrasounds similarly once you’ve met your deductible.
Without insurance, prices vary significantly by scan type and location. As of 2024, national average estimates look roughly like this:
- Abdominal ultrasound: $120 to $290
- Breast ultrasound (one side): around $350
- Transvaginal pelvic ultrasound: around $594
If you’re paying out of pocket, call the imaging facility ahead of time and ask for their self-pay rate. Many facilities offer a discount when you pay upfront without going through insurance.
How to Prepare for Your Scan
Preparation depends on what part of your body is being scanned. The imaging center will give you specific instructions when you schedule, but here are the most common requirements.
For an abdominal ultrasound, you’ll need to fast for eight hours before the exam. Water and prescribed medications are fine. Fasting keeps your gallbladder full and reduces gas in your digestive tract, both of which help the technologist get clearer images.
For a pelvic ultrasound, you’ll need a full bladder. The standard instruction is to drink 32 ounces of water (about four glasses) starting one hour before your appointment. A full bladder pushes the intestines out of the way and creates an acoustic window that lets sound waves reach the uterus and ovaries more clearly. You can use the bathroom if needed, as long as you keep drinking water to stay full.
If you’re having both an abdominal and pelvic ultrasound in the same visit, follow the fasting rule (no food for eight hours) but still drink the 32 ounces of water an hour before. The technologist will typically scan your abdomen first, then your pelvis.
What Happens During the Exam
Most ultrasounds take 30 minutes to an hour. You’ll lie on an exam table, and a technologist (called a sonographer) will apply a warm gel to the area being scanned. The gel helps the handheld probe make good contact with your skin so the sound waves transmit clearly. The sonographer moves the probe across your skin, capturing images in real time on a monitor.
For a transvaginal ultrasound, a thin, lubricated probe is gently inserted into the vaginal canal. This type of scan provides closer, more detailed images of the uterus and ovaries than an external pelvic ultrasound can. It’s not typically painful, though it can feel like mild pressure.
The sonographer may ask you to hold your breath briefly, shift positions, or roll to one side to get specific views. They can often see the images forming on screen in real time, but they generally can’t share results with you during the exam. That part comes from the radiologist.
Getting Your Results
After your scan, a radiologist reviews the images and writes a formal report. That report goes to the doctor who ordered the ultrasound, who then discusses the findings with you. This process typically takes a few business days, though it can be faster for urgent cases.
Many health systems now post radiology reports to online patient portals, so you may be able to see your results electronically before your doctor calls. Keep in mind that reading a radiology report without medical context can be confusing or anxiety-inducing. Terms like “heterogeneous echotexture” or “nonspecific finding” sound alarming but are often clinically insignificant. Your ordering doctor can put the findings in perspective.
Getting Copies of Your Images
Federal privacy law (HIPAA) guarantees your right to access your own medical images. If you want a copy of your ultrasound images, contact the facility where the scan was performed and ask their medical records department. You’ll sign a release form, and the facility will typically provide your images on a CD, a flash drive, or through a secure digital download. This is especially useful if you’re seeing a specialist at a different health system and want to avoid repeating the scan.