CPT 76805 is the standard anatomy ultrasound in pregnancy, usually done at 18 to 22 weeks. It checks the baby's organs, growth, placenta and amniotic fluid. It takes 30 to 45 minutes and is part of routine prenatal care.
What the price covers
The hospital's price is the technical fee for the machine, the sonographer and the room. The reading by a radiologist or maternal-fetal medicine specialist is billed separately. First-trimester ultrasounds (76801) and follow-up growth scans (76816) are different codes with different prices.
How this fits with a global maternity price
If your delivery is billed as a global package (59400 or 59510), routine prenatal visits are included but ultrasounds usually are not. Ask the practice which scans are inside the package and which are billed separately.
Why prices vary
The spread between hospitals is several times for the same scan. Obstetric practices with their own ultrasound equipment, and hospital-owned outpatient centers, are usually cheaper than the hospital's main imaging department.
Questions to ask
- What is the self-pay price for 76805, and does it include the specialist reading?
- Is the anatomy scan included in my maternity package?
- Can the scan be done at the practice or an outpatient site for less?