POV: you've decided you need point-of-care ultrasound (POCUS) in your clinical practise.  

Choosing the right ultrasound solution is a big decision, one that is influenced by several factors. Arguably, one of the largest being budget, a great place to start!

The ultrasound machine cost conversation may look considerably different if you are starting your own private clinic versus if you are part of a much larger organisation. The great news is the spectrum of ultrasound solutions is wide, ranging from premium cart-based systems to refurbished ultra-portable systems. Generally, point-of-care ultrasound systems are more cost-effective than traditional ultrasound systems. However, it is important to consider every factor that falls into the bucket of cost.  

This post describes what factors play into the cost of obtaining and maintaining a point-of-care ultrasound system, not just at the point of sale, but over the lifetime of a system – which also helps you understand where FUJIFILM Sonosite (FFSS) fits into the conversation. 

Types of Ultrasound Machines

Point-of-Care Ultrasound Machines

Portable

Portability has taken on different meanings since the inception of POCUS. What does portability mean to you? Does it mean you can wheel the system from room to room? Does it mean you can carry it in a backpack? Portability may have a unique definition to you and therefore, may have a wide cost range. Let’s define “portable” as the system meeting the patient where they are, whether that is via carrying or wheeling. Note that smaller portable ultrasound systems can be limited in technology and functionality compared to larger stationary systems, making them more cost-effective.

  • Examples: Sonosite PX/LX/ST, GE Venue Go/Fit, Mindray TE X/TE9/ME8/M9, Siemens ACUSON P500/Bonsai, Philips 5500/5300/Sparq, Samsung HS50/60/70
  • Price range: $20,000 - $100,000
  • FUJIFILM Sonosite’s latest product falls within this category, striving to deliver point-of-care ultrasound systems that are a total solution. Their goal is to partner with you and help you understand the total cost of ownership and what contributes to the sticker price. Included in the procurement cost of FUJIFILM Sonosite ultrasound systems are:
    1. Instalation
    2. Comprehensive training and education (including initial and follow-up)
    3. Industry-leading 5-year warranty on both the system and transducers (including accidental drops, overnight loaners, and shipment costs)
    4. System upgrades (including built-in software enhancements and optimisations)
    5. Ongoing, reliable service and support
    6. Data security
    7. No preventative maintenance (except the T8-3 transesophageal transducer).

Handheld

Handheld ultrasound systems fall into the category of ultra-portable, meaning you can carry the device in your hand from patient to patient. These include at least one transducer with the ability to connect to a smart device and are considered the most cost-effective, however their smaller size can limit functionality and user experience. Handheld systems can be prone to limitations related to image clarity, infection control, battery life, overheating, data security, and connectivity.

  • Examples: Butterfly iQ3, Clarius, GE Vscan Air CL/SL, Mindray TE Air, Philips Lumify, Exo Iris
  • Price range: $2000 - $10,000

Stationary/Cart-based Ultrasound Machines

Stationary cart-based ultrasound systems have been around the longest and are considered the traditional method of ultrasonographic evaluation. Before POCUS emerged, patients came to the system or radiology department. Today, most ultrasound systems can meet the patient where they are but may still have a home in a certain area or exam room. Cart-based ultrasound system costs can vary. A good rule of thumb is that a larger cart-based system will tend to have more robust capabilities and therefore come at a higher cost.

  • Examples: GE Logic (“Logiq”)/Voluson/Vivid, Philips EPIQ/Affiniti, Mindray Resona 7/Resona I9/DC-90, Siemens ACUSON S-series/Redwood, Samsung RS80/RS85, Canon i Series
  • Price range: $50,000-$150,000+

Factors Influencing Cost

Brand

Brand IS reputation and can have a major effect on cost. An ultrasound manufacturing company that is a leader in the market, at the forefront of innovation, and is known to be reliable will no doubt have a higher price tag.

  • Ask yourself what messages are conveyed to you by ultrasound manufacturers:
    • What do they value? Is it innovation? Durability/reliability? Ease of use? Education? Image clarity?
    • How does a product speak for itself among your peers?
    • What ultrasound systems did you learn on or have experience with? Did you like them? What do you remember about them?
  • Sonosite created the first ever portable ultrasound system, establishing the POCUS market, and continues to innovate by designing ultrasound solutions that enhance outcomes for both patients and clinicians. FFSS does not create products for any other market share besides point-of-care ultrasound.
  • Sonosite’s original mission was to create a military-grade system that was less than 10 pounds, made to withstand a 3-foot drop to any surface, and be easy to use in the toughest of environments. FFSS has maintained these durability and reliability standards in its product line to this day. 

Transducers & Accessories

  • The number of transducers a system needs may have the greatest impact on total procurement cost. A single transducer can cost several thousand dollars, which is why it is important to consider which transducers are essential to your practise.
  • Sonosite transducers are sold separately from the ultrasound system, allowing the flexibility to choose however many transducers are necessary for you. Our transducers are designed to be versatile and used across various applications. Transducer cost can vary depending on several factors such as GPO pricing, trade-in value, condition of transducer (new versus demo/used), type of transducer (i.e. transesophageal transducers typically cost more), available promotions, etc.
  • Accessories needed for the system may come at an extra cost. This includes items such as printers, additional storage options, additional power cords, etc. Consumable items such as ultrasound gel, disinfectants, printer paper, sterile drapes and covers, needles etc. have recurring costs over the lifespan of a system—however if you are part of an organisation, consumables may or may not be included in your budget. 

Technological Features

The following features may incur a higher cost:

  • High-resolution imageing.
    Broadband frequency, speckle reduction, compound imageing, fast frame rates, high sensitivity
  • Doppler
    Colour doppler, power doppler, pulsed wave doppler, continuous wave doppler
  • 3D/4D imageing
  • Voice control
  • AI capabilities
  • Shear wave and strain elastography
  • Advanced cardiovascular capabilities:
    • Stress echo, transesophageal echo
    • Compatibility with external systems like ABI machines or ECG
  • Number of transducer ports
  • Internal hard drive storage capacity
  • Wireless connectivity and image transfer
  • Advanced calculation packages
  • Other advanced features 

Age and Condition

New versus old
  • Typically, as ultrasound technology progresses and newer systems are released, the cost rises accordingly. The only exception is if a new system intentionally does not have certain capabilities to meet the needs of a specific market.
    For example, Sonosite released the Sonosite ST in 2023 with the intention of creating a streamlined workflow system for proceduralists, PICC teams, nurses, etc. – therefore priced lower than its predecessors, the Sonosite PX and Sonosite LX.
  • Purchasing an older system in a product line can be a cost-effective option. However, keep in mind that this is older technology which may not include the latest features and image clarity. Also note that products nearing end-of-life have limitations in replacement parts and support, as well as lower trade-in value when considering long-term value.
Refurbished and used
  • Typically, refurbished or used ultrasound systems cost less, which can be a great strategy to lower the barrier of entry. However, keep in mind that the source of the refurbished or used system can make a stark difference in the warranty, service, and support received after the point-of-sale. Purchasing indirectly or from a third party does not guarantee service support and repairs if a technical issue were to occur down the road. Refurbished systems can be restored to good as new condition. However, consider that any used product comes with risks, as you do not know what conditions the system may have endured prior to your purchase.
  • Sonosite sales teams sell their used demo equipment, including both systems and transducers, offering a lower cost option than purchasing new.

Non-Tangible Costs

Instalation and setup

Does the manufacturer offer in-person support to assemble your new unit and ensure it is properly connected and functioning?
Sonosite does not charge for onsite instalation and set-up on any ultrasound machine. With purchase of a Sonosite system, a local clinical specialist can arrive onsite to ensure the system is assembled, connected, and functioning to your needs.

Training and Education
  • Does the manufacturer charge for training on the system? What about follow-up training? 
    These are great questions to ask as some manufacturers and suppliers charge several hundred dollars per training event.
    Sonosite includes four hours of training with the system, which can be used at instalation or at a later date. They also offer both onsite and virtual clinical support, depending on preference.
  • Does the manufacturer charge for educational resources and workshops?
    All Sonosite customers have unlimited access to the Sonosite Institute, a free educational platform that contains webinars, module-based courses, and how-to videos across point-of-care specialties.
    Sonosite also supports workshops to deliver POCUS education.
Warranty

One benefit of purchasing an ultrasound system directly from the manufacturer is the warranty options that are available, often at no additional cost. Depending on the manufacturer, these can range greatly in coverage and price, so it is essential to determine which services and products are covered under the warranty options. Common types of warranties are:

  • Standard – typically comes at no cost upon purchase.
    Sonosite set an industry standard in 2005 by offering a 5-year standard warranty on systems and transducers at no extra cost. This includes system and transducer repair or replacement due to internal malfunction, protection for accidental transducer drops, and overnight loaners or replacements. More information here.
  • Extended warranty/coverage – option to extend length or add supplemental coverage to specific items, like transducers or accessories. This comes at an additional cost, usually up to several thousand dollars.
    • Sonosite offers Total SonoProtect, which offers additional coverage to the standard 5-year warranty, including the repair/replacement after abuse and mishandling, the transfer of SonoProtect with a system upgrade, along with many other benefits.
    • Sonosite also offers Point-of-Sale Warranty Plus, offering an additional two years of warranty coverage at the time of purchase at a discounted rate. This option is transferrable to a new Sonosite system should you choose to upgrade prior to the end of your 7-year warranty.
Maintenance

Maintenance costs may or may not be included when purchasing an ultrasound system. This can come in the form of a service agreement or contract, which can cost several thousand dollars. An important question to ask: do the ultrasound system and transducers require preventative maintenance?

  • Sonosite products are designed to the highest quality standards. Therefore, there are no recommended periodic or preventative maintenance requirements for Sonosite systems and transducers (except for the T8-3 transesophageal transducer).
  • Software upgrades may or may not be included in the cost over the lifetime of an ultrasound system. These include bug fixes, feature additions, software optimisations etc. Depending on the manufacturer, software upgrades can cost up to several thousand dollars.
    • Sonosite includes free software upgrades over the lifetime of their products. Exceptions may include features that require external hardware or offer significant additional value.
Trade ins and Upgrades

Trading in a used ultrasound system or transducers may lower acquisition cost. Trade-in value can range anywhere from several hundred to several thousand dollars, which could be significant relative to your new system's cost.

  • Sonosite allows trade-in value for working equipment, including their own and other ultrasound manufacturers.
  • There may be additional benefits or promotions offered when upgrading existing equipment.
    • Sonosite may incentivize loyal customers to upgrade to the latest technology by offering exclusive promotions, which could lower the cost of a new system. However, these promotions may vary from quarter to quarter and be based on system type.
Data Security and Regulation

Often overlooked, data security and regulation can play a key role in the cost of an ultrasound system. Ultrasound systems made by a manufacturer that undergo frequent regulatory processes and adhere to strict data security protocol in their design, will come at a higher cost than those that do not.

  • Through industry best practises, Sonosite ensures the security and privacy of its devices and the integrity of patients’ Protected Health Information (PHI) by designing and engineering their products in-house. Post market, FFSS actively monitors for potential cyber security issues that may affect the devices they manufacture. They work with industry peers and partners to share cyber security information to help the community quickly react to cyber threats. More information here.
  • Sonosite is a regulated medical device company, meaning proper documentation is required and internal audits are performed regularly for quality, regulation, and engineering.
Group Purchasing Organisation (GPO) affiliation

Being part of a larger organisation may have the benefit of GPO affiliation, which offer discounted rates on medical supplies to its members. GPO discounts can vary immensely but can save you one to several thousand dollars when purchasing an ultrasound system.

Sonosite sales representatives factor in your GPO discount when the time comes to review your quote.

Conclusion

There are many factors to consider when embarking on the journey of purchasing a point-of-care ultrasound system. Tangible costs have a significant effect on the upfront cost; however, it is important to weigh the non-tangible costs as these can have a significant monetary impact over the lifetime of the system. 

Consider your non-negotiables and be sure to ask the manufacturer or supplier specific questions regarding the factors outlined in this post:

  • Brand and model of ultrasound system
  • Transducers and accessories
  • Technological features
  • Age and condition
  • Non-tangible costs including:
    • Instalation
    • Training and education
    • Warranty
    • Maintenance
    • Trade-in value
    • Data security and regulation
    • GPO agreements

Sources:

How Much Does an Ultrasound Machine Cost – 11 Factors to Consider
Ultrasound Machines For Sale - Buy New or Used
GE Ultrasound Machines For Sale
Ultrasound Machines For Sale
Guide to Types of Ultrasound Machines