Medical Tourism: How We Saved $450 On Our First Ultrasound

A few weeks back, I reviewed how much an obstetric ultrasound should cost in the first trimester. We learned this service could run between $250 – $1,200 in the hospital setting in the United States. It is a much more reasonable $150 – $325 in a clinic or imaging center setting. The take-home was that unless it was an emergency, it might make sense to steer clear of the hospital for this kind of service.

It’s always best to get the right care, at the right place, at the right time.


But what if that place is Canada?

Photo of Canada showing where the ultrasound was provided.

Since the Max Out of Pocket crew is expecting in April 2021, we needed one of these ultrasounds back in September. It was September 18th, to be exact. Mrs. Max OOP happened to be studying meat cutting in Alberta at the time.

Unfortunately, I was not physically there to witness the first images of our baby.

But don’t worry, I still ran the numbers.

Although my wife is a Canadian citizen, she did not have her Canadian health insurance activated at this point. Evidently, it takes about three months and a commitment to stay in Alberta to become eligible. So, she had to pay cash. And when I say cash, I mean cold hard cash. They wouldn’t accept a credit card for payment.

Here in the United States, finance people like me would classify her as a “private pay” or “self-pay” patient.

But how much did we have to pay for this?

Ultrasound Recap

The CPT code that represents this first ultrasound in the States is 76801. It is an abdominal ultrasound of a uterus that has been pregnant for less than 14 weeks. The radiologist reviews the images of the fetus, pregnant uterus, and maternal pelvic structures and provides a written interpretation of the images back to the OBGYN.

Little Max or Maxine – apparently I didn’t miss much

In the States, there is a facility fee and a professional fee for this service.

The facility fee represents the equipment, supplies, and trained technician performing the actual ultrasound. You might also hear this called the “technical” component of the service. Unlike what you might have seen on daytime television, the obstetrician or midwife normally would not do the formal ultrasound where they take measurements. It is often farmed out to a trained sonographer. 

Then there is also a professional fee. This fee is for a radiologist to write a written report of their interpretation of the image. This is sometimes called a “read” fee for “reading” the image. Again, generally, the obstetrician or midwife wouldn’t necessarily do the formal interpretation of the image.

If there are any providers reading, please chime in if your experience is different.

Private Insurance

We would have gone to one of our local hospital here in New England for this first ultrasound. They would have charged us about $900 for the service. My $20,000 health insurance plan would negotiate that rate down to about $470 for the facility fee.  

Subsequently, we would have been charged another fee for the radiologist to read the image. My insurance would get that portion of the fee to about $70.

$470 Facility Fee + $70 Professional Fee = $540

Since it was late in the year and we had not received any healthcare services in 2020, both fees would have hit our family deductible of $3,300.

In other words, $540 would have come out of our pocket.


For this same ultrasound in the clinic or imaging center setting, my insurance would allow about $170. This payment would include both the facility (technical) fee and the professional fee for interpreting the ultrasound. When you combine these, it is considered the “global” fee.

That’s almost a $370 difference between the hospital and clinic setting.

We would have needed to travel about an hour and a half both to and from the ultrasound clinic to get this price.

As much as I hate to admit this, I would not have thought to send Mrs. Max OOP to an imaging center for a routine ultrasound. If the service were high-tech imaging services like an MRI or CT, sure, I would have researched it.  But I just would not have thought the pricing would vary so much from the hospital to a clinic/imaging center for a simple ultrasound.

I am a so-called expert and would have definitely been hit by the system here. The hospital’s imaging department is extremely convenient and close to the women’s health clinic we would go to. Taking an expensive walk down the hall to the hospital would have just been automatic.

Sure, it would also have taken a long and inconvenient drive to get the cheaper service. But that would certainly be worth it, considering all of this would be hitting our deductible.

Luckily, Mrs. Max OOP happened to be in Canada at the time.

Cash Price in Canada

My wife set up a temporary physician during her time in Canada.  This OBGYN handled her early care while she completed the meat cutting program.

Her doctor ordered an abdominal ultrasound after her first telehealth phone visit.  It was provided at the local imaging center. As I mentioned, she was not on the Canadian insurance at this point, so she had to pay cash.

Drum roll please.

Mrs. Max OOP’s mom knows I like to collect coins and gave me those new toonies several months ago. I decided to feature them in today’s post.

The total cash price came in at $109.06 (CAD). After a little google currency conversion, that came to a rock bottom price of $82 (USD) and included both the ultrasound and the professional read. I clarified with my wife, and she confirmed Canada did away with the penny and rounded this down to $109.05.

A penny saved is a penny earned.

$82 out-of-pocket

This saved us over $450 compared to what my insurance would “allow” at my local hospital.

$540 United States – $82 Canada = $458 in savings

Even if I had thought to go to an imaging center, we still saved $88. Here is proof if you need it.

Receipt from obstetric ultrasound showing $109.06 total due.

Final Thoughts

Since this was late in the calendar year, all of the services Mrs. Max OOP needed would hit our family deductible of $3,300. That deductible would then re-set on 1/1/2021, and we would start all over. For us, it sometimes pays to price these things out. For a routine ultrasound, we would have mistakenly gone to the hospital for this service.

But we lucked out. Mrs. Max OOP was in Canada until late December, and we accidentally saved $450.

I will be the first to admit that this is somewhat anecdotal. This is just one ultrasound in one imaging center in Canada. I have no idea how the rest of the country looks. So, I am not ready to declare Canada the go-to place for ultrasounds.

That said, I am beginning to wonder how much money we saved by having the wave of antepartum services provided in Canada. This one test alone easily covered the cost of her flights and even some lodging.

But now that we are safely in 2021 and fully expect to meet our max out-of-pocket, we will likely place convenience ahead of the price for the rest of the year.

Would you go to Canada for an ultrasound?



7 Responses

  1. David says:

    Congrats again! The first one is always the hardest 🙂

    For all of my kids, I didn’t even consider shopping around for ultrasounds. The biggest reason was probably because our insurance covered the ultrasound at the hospital right next to the women’s center, and I didn’t even consider that there was an alternative. But even if I was paying out of pocket, I probably would be hard pressed to drive/fly to a Canada for an ultrasound. Maybe if I lived closer.

    • Max OOP says:

      Thanks, David.

      The real question is how many ultrasounds did you have with all those kids! We are just 2-3 hours from Canada but it would take a lot more than $450 for me to make that drive. This was pretty much accidental savings.

      Have a good weekend.


  2. Dragon Guy says:

    Way to go being able to take advantage of cheaper prices in Canada. Especially knowing that you wouldn’t hit your out of pocket max in 2020. I read that Canada might start a required hotel quarantine process for people coming into the country. That might make it more difficult and expensive to do the medical tourism!

    • Max OOP says:

      Hi Dragon Guy,

      We had to quarantine for 2 weeks in a hotel when we went into Calgary back in August. We actually had to document our plans with border agents and Alberta Public Health. The process was really organized. But yes, in the current state of the world, it is not as easy as jumping the border for an afternoon to save $450 on an ultrasound.


  3. Medimentary says:

    Hey Max,

    Nice write up. I would be happy to receive any healthcare in Canada. As you show, they provide quality care at much lower prices. The difference in pricing ($82 vs $540) is one of the main reasons healthcare in the US is so expensive. Ewe Reinhardt was a Princeton health economist who published quite a bit on healthcare pricing and he argued that the US has a patchwork system with lots of moving parts and the price of each component of care (not necessarily the cost) is higher here than elsewhere. Wages, profits, and administrative costs get included in the price of care.

    There is a Health Affairs article (2019, Vol.38(1), p.87-95) that you may enjoy. It is entitled “It’s Still The Prices, Stupid: Why The US Spends So Much On Health Care, And A Tribute To Uwe Reinhardt.”

    On a side note, my cousin is a Maternal Fetal Medicine specialist (high-risk Obstetrician) and reads his own ultrasounds. I think a lot of Ob/Gyns read their own ultrasounds during prenatal visits.

    • Max OOP says:

      Thanks for the note, Dr. Medimentary. I will definitely check out that Health Affairs article. Looks like the is a subscription fee, or do you access through another avenue?

      Thanks for a note about your cousin – I made reference to your comment in the text above. I am wondering now if the MFM specialist has specific training for this, or if by chance the images are still read by a radiologist behind the scenes in case something is missed? I know for one of the EPIC ‘go-lives’ we had a similar situation come up where it was preferred for our EKGs to be read by a cardiologist rather than the regular provider.

      Or, perhaps they are looking at something so specific in the ultrasound that only an MFM specialist would know what he or she is looking at vs. a routine ultrasound where it almost seems to be a data/measurement gathering exercise? I am clearly outside of my finance wheelhouse, but I love the conversation.

      Perhaps since my experience is mostly with health systems (and in a lot of cases rural health), the third party interpretation is just them covering themselves? I will ask around the next time this comes up.


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