Somebody has quoted you a number and you can't tell whether it's normal.

It can be nothing. Public hospital care is free if you have Medicare. It can also run to many thousands. What catches most women out isn't the birth, though. It's the scans, the screening, and the few things no rebate touches at all.

There are only four kinds of cost

Everything you'll be charged for in this pregnancy is one of four things. Once you can tell which is which, the whole business gets a lot less murky.

Free. Public care, in a public hospital. You pay nothing.

Rebated. Medicare pays a set amount. The provider charges what it likes. The difference is yours, and it's called the gap.

Not rebated. Medicare pays nothing. You pay all of it.

Insurance. Only helps once you're admitted to a private hospital, and only if you've held the right cover for twelve months.

Most of the confusion comes from assuming something sits in one of those boxes when it sits in another.

Is public hospital birth free?

Yes. With Medicare, public maternity care costs nothing. Your appointments, the birth, your stay afterwards, your midwives and doctors.

There are edges. Some ultrasounds and some genetic screening still cost money inside the public system. It depends on whether your hospital has its own imaging department, and whether it will bulk bill you.

If money is a problem, say so. Some hospitals can bulk bill your scans through their own department. Some can point you to something subsidised. None of that happens if nobody knows.

You should not go without a recommended scan because you can't afford it. Have the conversation. It isn't an embarrassing one.

What does a private obstetrician cost out of pocket?

It varies a great deal, and it arrives as two separate bills that people often muddle.

The first is the obstetrician's own fee. It's usually charged as a per-appointment rate for your antenatal and postnatal visits, plus a pregnancy management fee, plus a fee for the birth. In my experience the total tends to land somewhere between six and twelve thousand dollars. There's a wide spread either side of that, and every doctor sets their own.

The second is the hospital's fee. If you have private hospital cover, this is where it applies, and you'll usually pay an excess or co-payment rather than the lot. Some obstetricians also hold appointments at public hospitals, which changes that side of things considerably.

The only way to know your number is to ask that obstetrician for a written breakdown before you book. What's included, what isn't, when each payment falls due, and what happens if you end up with a caesarean or a longer stay.

Some background worth having. The share of Australian babies born in private hospitals has dropped from close to 40% thirty years ago to under 20% now, and 22% of that fall happened between 2012 and 2023. Cost is one of several reasons. Around 40% of women who start with a private obstetrician don't finish there.

Does Medicare cover a private midwife?

Partly. The detail matters.

Rebates exist for antenatal and postnatal care with an eligible midwife. So your appointments during pregnancy, and your care afterwards, work much like seeing a specialist.

The birth is different. There are Medicare items for a midwife managing labour and birth, but they only apply if you're an admitted patient of a hospital. Your midwife needs an access arrangement with that hospital for them to be claimable.

Which means a planned homebirth with a private midwife carries no Medicare rebate for the birth. The antenatal and postnatal care still can. The birth can't.

Fee structures vary between midwives the way they do between doctors. Some bulk bill. Some charge upfront and you claim the rebate back. Ask.

What is an Endorsed Midwife, and why does it matter for rebates?

Endorsement is a formal notation on a midwife's registration. It takes additional postgraduate study and a set volume of recent practice across the full scope of midwifery care.

An Endorsed Midwife can prescribe certain medicines, order certain tests, and access Medicare item numbers and the PBS.

For you, it's simply what makes a rebate possible. A midwife practising privately without it can't generate a Medicare rebate for your appointments, however experienced she is.

So if rebates matter to your budget, ask whether she's endorsed and whether she has a Medicare provider number. Those are two different questions, and you want yes to both.

Do I need private health insurance to have a baby?

No. Absolutely not.

You can have excellent care in the public system at no cost, and plenty of women who hold private cover give birth in public hospitals anyway. Usually because of the model of care rather than the money.

Insurance is also a smaller part of this picture than people assume. In early 2024, maternity made up only about 5% of private health insurance hospital payouts.

What it buys you is a private hospital, your choice of obstetrician, and a private room if one's free. It does not cover your appointments outside hospital. It does not cover the obstetrician's gap. It does not cover your scans or your screening.

And if you're birthing at home with a private midwife, there's no hospital and no co-payment. It's her fee and that's it.

What's the waiting period for pregnancy cover?

Twelve months. Every fund. It's set by law, not by the insurer, so there's no negotiating and no shopping around for a shorter one.

The wait runs before your hospital admission rather than before conception. But since a pregnancy is about nine months, in practice you need the right cover in place before you conceive for it to help with this baby.

If you're on a lower level of cover and thinking about upgrading, the twelve months usually applies to the upgrade too. Ring your fund and get that in writing before you pay for anything.

What does homebirth cost?

Two answers, depending which kind.

A publicly funded homebirth program costs nothing. These run out of some public hospitals, including in Sydney, and they're covered like any other public maternity care. Places are limited and there are eligibility criteria, so what stands in the way is usually availability rather than money.

A private midwife in Sydney typically charges somewhere between five and a half and seven and a half thousand dollars. It shifts around New South Wales depending on where you are and what's included.

That fee covers more than most people expect. Your antenatal care, the birth, postnatal care in your own home, the second midwife who comes to the birth, the hire or loan of a birth pool, and all the medications and equipment she brings with her (most of which never gets opened). It also buys a defined on-call period, where she isn't travelling, isn't on holiday, and is available to you.

Medicare rebates can still apply to the antenatal and postnatal parts of that care if she's endorsed, which brings the real figure down.

Everything else about a homebirth is usually small. A liner for the pool. Extra towels. The same blood test and ultrasound gaps everyone else pays. Mostly you don't need to buy anything to have a baby.

Why does the same scan cost different amounts?

This is where most women get caught, because what a scan costs has almost nothing to do with the scan.

Medicare sets a schedule fee for each type of pregnancy ultrasound and pays a fixed rebate against it. As at September 2026, a dating scan before twelve weeks has a schedule fee of $70.65, and Medicare pays $60.10 of that.

The practice then sets its own fee, and it can be anything. The rebate doesn't move. So what you pay is decided entirely by what that practice chose to charge.

Which means the same scan, the same Medicare item, the same rebate, can cost you nothing at one practice and well over two hundred dollars at another a few suburbs away.

Specialist women's imaging practices generally sit at the top, and there are reasons for that which aren't about profiteering. They scan pregnancies all day. Their reporting is done by obstetricians or fetal medicine specialists. They hold the certification needed to measure nuchal translucency.

For context, 87% of Medicare-subsidised pathology, imaging and diagnostic services were bulk billed across Australia in 2024–25. Of the women who did pay for ultrasound, the average came to around $204 across a year.

So when you ring to book, don't ask what it costs. Ask what you'll pay, and whether they bulk bill.

What do the routine scans cost?

These are out-of-pocket ranges at private practices across Greater Sydney, after the Medicare rebate, as at September 2026.

The bottom of each range is a practice that bulk bills that scan. The top is a specialist women's imaging practice. Both exist here, and both are doing the same Medicare item.

What the routine scans and tests cost

Here's the shape of it. These are out-of-pocket ranges at private practices across Greater Sydney, after the Medicare rebate, as at September 2026.

The bottom of each range is a practice that bulk bills that scan. The top is a specialist women's imaging practice. Both exist in Sydney and both are doing the same Medicare item.

These are out-of-pocket ranges at private practices across Greater Sydney, after the Medicare rebate, as at September 2026. The bottom of each range is a practice that bulk bills that scan. The top is a specialist women's imaging practice. Both exist here, and both are doing the same Medicare item.

Test or scan	When	Medicare rebate	What you'd pay
Dating / viability scan	6–12 weeks	$60.10	$0 to $220
Nuchal translucency scan	11+0 to 13+6 weeks	$70.15	$150 to $390
Combined screening bloods	9–13 weeks	$33.80	$0 to $50
Early structural scan	12–16 weeks	$70.15	$150 to $390
NIPT	from 10 weeks	no rebate	$435 to $800
Morphology scan	19–21 weeks	$100.20	$100 to $420
Third trimester growth and wellbeing	22+ weeks	$115.15	$100 to $370

Twins cost more, usually 25% to 50% on top, because the scan takes longer. Extra scans aren't in this table and they're common. They're charged the same way.

Figures current at September 2026. Medicare fees are reviewed at least annually and practice fees change without notice. Check with the provider before you book.

A few notes on reading this table.

The nuchal translucency scan and the early structural scan are often the same appointment, or billed under closely related items. If you're having combined screening, the NT scan is the one you book.

Extra scans aren't in the table and they're common. Bleeding, a previous loss, an uncertain date, anything that needs following up. They're charged the same way.

And look at where NIPT sits. It's the only line with no rebate at all, and it's the single most expensive item in a routine first trimester.

Can I find a scan that's bulk billed?

Often, yes, and ten minutes of ringing around is time well spent.

Several private radiology groups across Greater Sydney bulk bill at least some pregnancy scans. A few bulk bill the dating scan outright, at every one of their practices. Others bulk bill most obstetric scans and charge a modest gap only on the later ones. At least one caps how many scans you can be charged for across a whole pregnancy.

Some things to know before you start calling.

"Bulk billed ultrasound" on a website doesn't always take in pregnancy scans. Some practices advertise bulk-billed imaging and then quietly exclude obstetrics. So ask about your scan, not about ultrasound in general.

Concession and pension card holders are bulk billed far more widely than everybody else. If you hold a card, say so when you book. Some practices will also bulk bill at their own discretion where there's genuine financial need, but you have to ask.

And a practice that bulk bills may not do nuchal translucency. That measurement needs current certification and not everyone holds it. If you want combined screening, check before you book on price.

Your midwife or GP will usually know who bulk bills near you, and it changes often enough that asking a person beats reading a website.

A first trimester of scans might come to nothing at all, or to several hundred dollars.

What does genetic screening cost?

Screening for chromosomal conditions is available to every woman in Australia. It's optional. And the two main pathways sit in completely different cost boxes, and deserves to be explained.

Combined first trimester screening is mostly rebated. It's two tests: a blood test around nine to ten weeks measuring two markers, and a nuchal translucency ultrasound between 11+0 and 13+6 weeks. Both attract a Medicare rebate. The blood component has a schedule fee of $39.75 with a rebate of $33.80, claimable once per pregnancy, and the scan is rebated like any pregnancy ultrasound. So you pay whatever gap the providers charge, which is usually modest and sometimes nothing.

NIPT attracts no Medicare rebate at all. None. Private health insurance won't cover it either. Whatever the test costs, you pay all of it, and that's commonly four to eight hundred dollars depending on which test and how much it looks for.

Four things to know before you decide:

You can decline all of it. Screening is offered, not required, and saying no doesn't affect the rest of your care.
You can have combined first trimester screening without NIPT. It's a real test with a real result, not a consolation prize.
If you have NIPT you are still recommended a scan. It's a blood test. It can't see the baby.
Some laboratories may include genetic counselling at no extra cost if a result comes back high-probability, however public hospitals also have access to genetic counselling so you can seek referral to your local high risk clinic for further testing/ care which can reduce ongoing costs.

If cost is what's actually driving your decision, say so to your midwife or doctor. It's a legitimate reason and it's better on the table than under it.

The Medicare Safety Net

If you're paying gaps all year, this is the one thing that gives some of it back.

Once your out-of-hospital costs reach a threshold within a calendar year, Medicare starts paying more. As at 2026:

Original Medicare Safety Net, threshold $594.00. Past it, Medicare pays 100% of the schedule fee instead of 85%.
Extended Medicare Safety Net, threshold $861.20 if you hold a concession card or receive Family Tax Benefit Part A, or $2,699.10 if you don't. Past it, Medicare pays 80% of your out-of-pocket costs.

There's a catch in that second one. It pays 80% of your gap or a capped amount for that item, whichever is lower. On a dating scan the cap is $40.70. So if you're wearing a two-hundred-dollar gap, you get forty dollars back, not one-sixty.

Still worth having. Two things make it work properly: register your family with Services Australia so your costs count together rather than separately, and keep your receipts.

What isn't covered by anything

Short list. Read it before you build a budget.

Ultrasounds, in the sense that the rebate rarely covers the fee. Recommended, sometimes several times over, and almost never free unless you find a practice that bulk bills.

NIPT, entirely. No rebate, no insurance.

Some genetic and pathology testing beyond the standard panel, partly or entirely.

Birth education. Classes, workshops and courses cost money almost everywhere, hospital-run ones included. Prices vary enormously, so look around.

Physiotherapy, lactation consultants, osteopathy and the rest. A small rebate under an extras policy if you have one, and nothing from Medicare unless it's part of a specific care plan.

Cost isn't the only question

Money is a real factor and pretending otherwise helps nobody. But two questions tend to collapse into one here, and they're worth pulling apart.

What can I afford?

And what kind of care do I actually want?

The cheapest option and the right option are sometimes the same. Sometimes they aren't. Continuity, whether you'll know the person at your birth, how far you'll have to travel, whether the model suits your circumstances: none of that tracks neatly with price.

Work out what matters first. Then work out what it costs.

One thing worth doing

Before you commit to anything, ask whoever you're considering for a written breakdown of their fees. Then ring the ultrasound practice and ask what your out-of-pocket will be.

Two phone calls, about five minutes. They're the difference between knowing and finding out.

This is general information about pregnancy, not advice about you. It doesn't replace the care of your own midwife, GP or maternity service, and it can't account for what's particular about your pregnancy.

If you're worried about yourself or your baby, contact your maternity service or go to your nearest emergency department. Don't wait to be sure.

Sources referenced on this page

Medicare Benefits Schedule, items 55700, 66750, 82120. mbsonline.gov.au
Medicare Safety Net Arrangements, 1 January 2026. Department of Health, Disability and Ageing
Private Health Insurance Ombudsman, Obstetrics and Pregnancy factsheet. ombudsman.gov.au
Australian Institute of Health and Welfare, Pathology, imaging and other diagnostic services, 2024–25. aihw.gov.au
Private maternity hospitals: extinct by the end of this decade? InSight+, Medical Journal of Australia, 2024. insightplus.mja.com.au
Nursing and Midwifery Board of Australia, Endorsement for scheduled medicines registration standard. nursingmidwiferyboard.gov.au
Pynaker C et al. 'Screening should not be based on ability to pay': Australian healthcare providers' and consumers' perspectives on public funding for non-invasive prenatal testing. Aust N Z J Obstet Gynaecol, 2025.

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