Costs of Common Prenatal Tests

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When you’re pregnant, you should have regular prenatal visits with a medical provider, usually an obstetrician, a midwife or your family practitioner. Besides measuring your blood pressure, weight, abdomen size and fetal heart rate, the doctor might order tests to screen for potential pregnancy problems or birth defects. Some of these tests are recommended for all pregnant women as part of preventive prenatal care, and should be fully covered by insurance, with no cost to you. These include routine screenings for gestational diabetes, anemia, bacteria in your urine, and a number of sexually transmitted infections.

Other tests are available to look for chromosomal abnormalities or other problems with the pregnancy. Depending on your insurance plan specifics, you may have to help cover their cost. Below, you’ll find information about some the most common tests women get during pregnancy:

First Trimester Prenatal Screening Tests

What are they?

A combination of an ultrasound and a blood test, each looking at specific factors that can indicate the presence of a birth defect. The ultrasound is performed between 11 and 14 weeks and will measure the back of your baby’s neck, among other parts of the anatomy. A thickening or fluid build up there may suggest Down syndrome. A blood test measures the hormone, human chorionic gonadotropin (hCG), and a protein from the placenta. Abnormal levels of either can indicate a chromosomal abnormality.

Who gets it?

It’s generally offered to all pregnant women.

How much do the first trimester prenatal screening tests cost?

The costs vary by healthcare provider and insurance provider, but should fall into a typical range for blood tests and pregnancy ultrasounds. Healthcare Bluebook, a company that offers information on medical pricing, suggests a fair price for the hCG test is $39, for example. The cost of a fetal ultrasound is usually around $280. However, women have reported bills as high as $600 for these screenings, so check with your provider about the costs if you’ll be footing the bill.

What will you pay?

If you’re uninsured, you’re responsible for the entire amount. If your insurer classifies these tests as routine prenatal care, they may be covered with no cost to you. Otherwise, your share of the payment is determined by the structure of your insurance plan. For example, you might have a $25 co-pay for laboratory tests (the bloodwork), and a $75 co-pay for radiology procedures (the ultrasound.) Or you might be responsible for all costs up to your deductible, and a percentage of them after that, until you reach your out-of-pocket maximum for the year.

Second Trimester Prenatal Screening Tests

What are they?

Prenatal screen tests that are common during the second trimester include: blood tests for things like alpha-fetoprotein (AFP), hCG, Estriol, and Inhibin. Abnormal results may mean you need additional testing.

Who gets it?

These are typically offered to all pregnant women.

How much second trimester screening tests cost:

A fair price for the AFP test is $43, according to HealthCare Bluebook. For Estriol, it’s $63. Check with your healthcare provider and/or your insurance plan to find out what it will cost you.

What will you pay?

Uninsured women will be responsible for the entire amount. If the tests are considered routine prenatal care by your insurer, they may be covered with no cost to you. Otherwise, your cost will depend on how your plan is set up. You might have a co-pay for the bloodwork, even if you’ve already reached your deductible. However, you should never have to pay more than your out-of-pocket maximum, as long as you get your services in-network.

Chorionic Villus Sampling (CVS)

What is it?

Between the 10th and 12th week of pregnancy, a doctor takes a small sample of placental tissue. It has the same genetic make-up as the fetus, and can be examined for chromosomal abnormalities, but not for neural tube defects. (For that, you may need an amniocentesis.)

Who gets it?

Women at risk of chromosomal abnormalities like Down Syndrome, and those who have a specific genetic disease in their family history like Tay-Sachs or Cystic Fibrosis. CVS allows an earlier diagnosis of this type of problem, compared to amniocentesis.

How much does CVS cost?

Women have been quoted prices between $1,300 and $4,800.

What will you pay?

What will you pay? Your health insurance may cover chorionic villus sampling if you have certain risk factors, like older age or a family history of certain genetic diseases, though you might have to help pay its costs.You may also need to get prior authorization from the insurance company. The test can result in various fees, including for the physician, the lab, and the procedure, and your portion will depend on your insurance plan.

Amniocentesis

What is it?

In this procedure, which is usually performed after 15 weeks of pregnancy, a small needle is inserted through the abdomen to obtain a sample of amniotic fluid. Cells in the fluid are checked for chromosomal problems or open neural tube defects. They can also be checked for specific genetic abnormalities, based on the family’s history.

Who gets it?

Pregnant women at increased risk for any chromosomal abnormalities in their fetus, such as women over 35, those with a family history of certain genetic diseases, or those who had abnormal screening tests earlier in their pregnancy.

How much does an amniocentesis cost?

Women report quotes for an amniocentesis between $1000 and $7200.

What will you pay?

Most insurance plans will cover the test if you have risk factors for chromosomal abnormalities in your baby, but you might have to help pay for the costs. Some insurers require prior authorization for an amniocentesis, so it’s best to call the number on the back of your card to find out the specifics. An amniocentesis can lead to various bills, like for physician fees, procedure fees, and lab fees. Your portion will depend on your insurance plan. Without insurance, you’d be responsible for the entire cost.

Other Common Tests During Pregnancy

Other tests a pregnant woman might need include genetic tests, a group B strep culture, fetal monitoring, or a 24-hour urine test for preeclampsia. As with the other examples, her costs will depend on whether or not she has insurance, how much her provider bills for them, and how her insurance covers them.

While more plans are charging more of the costs of care to the insured patient in recent years—average deductibles for both in- and out-of-network care have more than doubled since 2009, according to the Advisory Board—some still have generous coverage for pregnancy.

Women who’ve been pregnant in recent years, especially those who are insured through large employers, have reported relatively reasonable co-pays and other out-of-pocket costs. Still, read your own plan literature closely, and make a careful selection when you choose a health insurance plan, if pregnancy costs are in your future.

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