A breast ultrasound is a common, non-invasive diagnostic tool that uses high-frequency sound waves to create real-time images of the breast’s internal structures. This procedure is frequently used to investigate specific areas of concern identified during a physical exam or to provide a closer look at findings from a recent mammogram. Because it does not use ionizing radiation, an ultrasound is a safe and effective way to help determine if an abnormality is a fluid-filled cyst or a solid mass. It supplements other imaging methods, offering detailed information for a complete assessment of breast health.
Identifying Appropriate Imaging Facilities
The quality of your breast ultrasound depends on the facility and the technical expertise of the personnel performing and interpreting the exam. Breast ultrasounds are typically performed in two settings: the radiology department of a hospital or a specialized outpatient breast imaging center. While both use the same core technology, outpatient centers may offer more streamlined scheduling and shorter wait times compared to a large hospital system.
When selecting a location, look for facilities that have received accreditation from the American College of Radiology (ACR). The ACR’s Breast Imaging Center of Excellence (BICOE) designation indicates the facility has undergone a rigorous review process. This accreditation confirms that the center meets high standards for image quality, equipment maintenance, and the qualifications of its personnel, including technologists and interpreting radiologists.
Securing a Referral and Scheduling the Exam
A formal referral is almost always required for a diagnostic breast ultrasound, which is performed to investigate a specific finding. This order must come from a licensed practitioner, such as your primary care provider or specialist, to confirm the medical necessity of the procedure. The referring provider’s office is responsible for submitting this order to the imaging center you have chosen.
Before scheduling, confirm that the imaging center has received the referral paperwork from your doctor. When contacting the facility, have your insurance card, the name of your referring provider, and any relevant prior imaging reports available. Providing details about previous mammograms or biopsies ensures the radiologist can compare the new ultrasound images with your existing breast health history.
What to Expect During the Breast Ultrasound
Preparation for a breast ultrasound is minimal, but avoid applying powders, lotions, or deodorants to your chest and underarm area on the day of the exam. These substances can create artifacts on the images, potentially obscuring details. Upon arrival, you will remove clothing from the waist up and put on a gown that opens in the front.
During the procedure, you will lie on your back on an examination table, and the sonographer will ask you to raise the arm on the side being examined over your head. A warm, water-based gel is applied to the skin over the area of interest to allow high-frequency sound waves to transmit effectively. The sonographer then uses a handheld probe, called a transducer, moving it against the breast to capture images.
You will feel slight pressure from the transducer as the technologist works, but the procedure is generally painless. The exam typically takes between 15 and 30 minutes, depending on the complexity of the area being studied. After the images are captured, the sonographer will wipe off the gel, and you will be free to get dressed. A radiologist, who specializes in interpreting these images, will analyze the scan and prepare a formal report for your referring provider.
Understanding Costs and Insurance Coverage
The cost of a breast ultrasound depends on whether your insurance plan classifies it as a screening or a diagnostic procedure. Screening ultrasounds, sometimes recommended for women with dense breast tissue, may be covered as preventive care without cost-sharing in some states. However, a diagnostic breast ultrasound, performed due to a specific symptom or abnormal finding, is treated differently.
Diagnostic procedures are subject to standard insurance benefits, meaning you may be responsible for a co-pay, co-insurance, or meeting your annual deductible. To avoid unexpected bills, contact your insurance provider before the appointment. Inquire about pre-authorization requirements and ask the facility for the specific Current Procedural Terminology (CPT) code they plan to use for billing. This information allows your insurer to provide an accurate estimate of your out-of-pocket costs.