03/15/2026
If you don't know by now, many of my posts arise out of irritation with conventional health care. Today is no exception. Over the last year I've seen a resurgence of unnecessary testing, maternal-fetal medicine consultations, and imaging being recommended in pregnancy that drive up costs—especially for patients with high-deductible plans. Here’s a tidbit worth knowing.
It is not evidence-based to offer both an NT (nuchal translucency ultrasound) and an NIPT (non-invasive prenatal screening blood test).
NIPT is ~99% sensitive for screening Trisomy 21/Down syndrome, does not require a visit to maternal-fetal medicine or genetic counseling, is covered by most major insurers, and can be drawn with your initial prenatal labs. If someone has to self-pay, it’s $199 with my lab.
An NT is 60–80% sensitive with a 5% false-positive rate. In other words, it doesn’t come close to the accuracy of NIPT. Once NIPT became widely available, routine NT screening largely fell out of favor more than a decade ago.
Yet I’m seeing a resurgence of the NT + NIPT combo in large health systems. Why? My suspicion: it generates revenue for MFM departments.
What gets billed?
• hospital facility fee
• dating ultrasound
• genetic counseling visit
• perinatologist interpretation
• the blood test
Total charges to insurance often land between $1,300–$2,300.
While I try not to stoke skepticism toward conventional medicine, patients deserve to know when recommendations are evidence-based—and when they may simply pad a system’s bottom line.
Take-home: work with a provider who understands the realities of corporate healthcare, practices evidence-based medicine, and doesn’t profit from the tests they recommend. Ya welcome!