Getting an ultrasound starts with a doctor’s order. In nearly all cases, you’ll need a referral from a physician, nurse practitioner, or physician assistant before a facility will schedule a diagnostic ultrasound. Here’s what the process looks like from start to finish, including what it costs, how to prepare, and how long you’ll wait for results.
You’ll Need a Doctor’s Order First
Diagnostic ultrasounds require a signed order from a treating clinician, whether that’s your primary care doctor, an OB-GYN, or a specialist. The order must document a specific clinical reason for the scan, such as abdominal pain, a suspicious lump, or pregnancy monitoring. Facilities that bill Medicare or private insurance are required to have this documentation on file, and unsigned orders or missing paperwork will result in denied claims.
If you think you need an ultrasound, the first step is scheduling an appointment with your doctor and describing your symptoms. If they agree the scan is warranted, they’ll write the order and either perform the ultrasound in their own office (many OB-GYN and cardiology practices have machines on-site) or refer you to a radiology center or hospital imaging department. Some urgent care clinics can also write ultrasound orders for acute symptoms like severe abdominal pain or suspected blood clots.
The One Exception: Elective Prenatal Scans
Boutique or “keepsake” ultrasound studios offer 3D and 4D images of a developing baby without a doctor’s order. These scans are designed for bonding and photos, not diagnosis. They’re performed by non-medical personnel using consumer-grade equipment, and they can’t replace a medical ultrasound for detecting abnormalities or guiding clinical decisions. If you’re considering one, keep in mind that these studios don’t follow the same safety protocols as medical facilities, and the images aren’t reviewed by a radiologist.
How to Prepare for Your Scan
Preparation depends on which part of the body is being scanned. For an abdominal ultrasound, you’ll typically need to fast for 8 to 12 hours beforehand. This prevents gas buildup in the abdomen, which can obscure the images. Ask your care team whether plain water is allowed during the fasting window.
For a pelvic or transvaginal ultrasound, you may be asked to drink a specific amount of water beforehand and arrive with a full bladder, which pushes the intestines out of the way and gives the technician a clearer view of the uterus and ovaries. For most other scans, like breast, thyroid, or vascular ultrasounds, there’s usually no special preparation. Keep taking your regular medications unless your doctor specifically tells you to stop.
What Happens During the Scan
The ultrasound itself is painless and usually takes 20 to 45 minutes. A sonographer applies warm gel to your skin and moves a handheld probe over the area being examined. The probe sends sound waves into your body and captures the echoes to build a real-time image on a monitor. You may feel light pressure, especially if the sonographer needs to press firmly to see deeper structures.
For a transvaginal scan, a thin, lubricated probe is inserted into the vaginal canal. This can feel slightly uncomfortable but shouldn’t be painful. For a vascular study, like a carotid or leg vein ultrasound, the sonographer may apply and release pressure on the vessel to check blood flow patterns. In all cases, you’ll be lying on an exam table, and the sonographer may ask you to change positions or hold your breath briefly to get better images.
How Long Results Take
A radiologist reviews your images after the scan and writes a report for your ordering physician. In emergency settings, results often come back within an hour. For outpatient scans, most reports are completed within 24 hours. Your doctor’s office then contacts you with the findings, which in practice means you’ll hear back within one to three business days. Some patient portals make the radiologist’s report available online before your doctor calls, though the report will be written in medical terminology.
Cost With and Without Insurance
The average cost of an ultrasound in the United States is about $400 without insurance, though prices range from $200 to over $1,000 depending on the type. A breast ultrasound averages around $350, a routine prenatal scan about $459, and more complex studies like a carotid ultrasound can run close to $775. A specialized fetal ultrasound averages around $954.
With insurance, your out-of-pocket cost depends on your plan’s deductible and copay structure. Medicare and most private insurers cover diagnostic ultrasounds when they’re ordered for a documented medical reason: specific symptoms, abnormal findings, or monitoring a known condition. What insurers won’t cover are screening ultrasounds performed without symptoms or clinical indication, unless a specific preventive screening is authorized by law. Before scheduling, call your insurance company with the procedure code from your doctor’s order to confirm coverage and estimate your share of the cost.
Where to Get the Best Price
If you’re paying out of pocket or have a high deductible, the facility you choose matters. Hospital-based imaging departments tend to charge significantly more than freestanding radiology centers or imaging clinics because hospitals add facility fees. An identical abdominal ultrasound could cost two to three times more at a hospital than at an independent clinic across the street. Ask your doctor if they can refer you to a freestanding center, and call ahead to get a cash-pay quote. Many imaging centers offer discounted rates for patients who pay upfront without insurance.