Ultrasound Center Running Costs: $112k Monthly, 17-Month Payback;

Ultrasound Center Running Costs

Running an Ultrasound Center requires high upfront capital expenditure (CapEx), but monthly operating costs are dominated by specialized labor Expect initial monthly running costs in 2026 to be around $112,000, driven primarily by payroll and facility expenses Payroll accounts for roughly 65% of this total, with fixed overhead adding another $20,800 per month The business model shows strong potential, projecting $368,000 in EBITDA in Year 1, but requires a significant cash buffer You must secure at least $493,000 in working capital to cover the minimum cash point reached in April 2026 This analysis breaks down the seven core recurring costs, helping founders manage cash flow and reach the 17-month payback period faster

7 Operational Expenses to Run Ultrasound Center

#	Operating Expense	Expense Category	Description	Min Monthly Amount	Max Monthly Amount
1	Specialized Payroll & Benefits	Payroll	In 2026, payroll for 75 FTE staff (including sonographers, radiologists, and admin) totals about $72,708 per month, making it the largest expense.	$72,708	$72,708
2	Facility Rent	Fixed	Facility rent is a major fixed cost, budgeted at $10,000 per month, which must be secured by a long-term lease agreement.	$10,000	$10,000
3	Medical Software (RIS/PACS, EHR)	Software	Essential operational software (RIS/PACS and EHR/Billing) runs $3,800 monthly, critical for compliance and efficient billing processes.	$3,800	$3,800
4	Equipment Service Contracts	Maintenance	Maintaining high-end ultrasound machines requires $2,500 monthly for service contracts to minimize downtime and ensure diagnostic quality.	$2,500	$2,500
5	Utilities and Office Overhead	G&A	Basic facility operations, including utilities ($1,500) and office supplies/cleaning ($800), add $2,300 to the monthly fixed costs.	$2,300	$2,300
6	Insurance (GL/Malpractice)	Risk	General liability and malpractice insurance are non-negotiable costs, budgeted at $1,200 per month to mitigate professional risk.	$1,200	$1,200
7	Variable Medical Supplies	Variable	Direct medical supplies, like gel and disposables, are variable costs estimated at 20% of revenue, or about $3,079 monthly in 2026.	$3,079	$3,079
Total	All Operating Expenses	All Operating Expenses		$95,587	$95,587

What is the total monthly operating budget required to sustain the Ultrasound Center for the first year?

The total monthly operating budget for the Ultrasound Center must start with the $20,800 fixed overhead, but the true requirement hinges on accurately budgeting for the substantial payroll supporting 75 full-time employees (FTE) and all necessary software subscriptions; for context on potential earnings against these costs, check out How Much Does The Owner Of Ultrasound Center Typically Make?

Monthly Fixed Cost Baseline

Base fixed overhead is set at $20,800 monthly before personnel costs.
Payroll for 75 FTE staff represents the single largest recurring expense category.
This base figure excludes operational supplies and per-scan variable expenses.
Budget for benefits packages associated with 75 employees must be layered on top.

Operational Cost Drivers

Variable costs, like consumables and utility spikes, must be modeled separately.
Software subscriptions for imaging systems and EMR (Electronic Medical Record) need monthly allocation.
If onboarding referring physicians takes 14+ days, service reliability risk rises.
You defintely need a contingency buffer for unexpected equipment maintenance.

Which cost categories represent the largest recurring monthly expenses?

Specialized payroll is defintely the largest recurring expense for the Ultrasound Center, consuming 65% of the core operating budget, while facility rent ($10,000) and critical software ($3,800) make up the remaining 35%. Understanding these fixed costs is crucial before looking at startup capital, which you can explore in How Much Does It Cost To Open An Ultrasound Center?. The total baseline recurring expense calculated from these figures is approximately $39,429 per month.

Core Cost Distribution

Specialized payroll accounts for 65% of the identified fixed costs.
Facility rent is a fixed $10,000 per month.
Critical software subscriptions total $3,800 monthly combined.
The remaining 35% covers rent and software costs.

Impact of Utilization

High payroll means utilization must stay high.
Every hour a sonographer sits idle costs money.
Rent is fixed regardless of how many scans occur.
Focus on securing physician referral volume immediately.

How much working capital is required to cover operations until the business is cash-flow positive?

You need to secure funding that covers operational deficits until the Ultrasound Center hits its lowest cash point, which is projected to be $493,000 in April 2026. This minimum capital requirement is crucial for bridging the initial ramp-up, and you should review Is The Ultrasound Center Currently Achieving Sustainable Profitability? to understand the path past this hurdle. That $493,000 is the hard floor you must cover with committed financing.

Covering the Cash Trough

Identify the $493,000 minimum cash point projection date: April 2026.
Ensure committed debt or equity financing exceeds this figure plus a 15% contingency buffer.
Map monthly cash burn rates against physician onboarding success.
If patient scheduling takes longer than 7 days, runway shortens fast.

Bridging to Positive Flow

This capital covers the operational deficit before positive cash flow starts.
The goal is to minimize the time spent below this $493k threshold.
Focus initial spending on securing high-volume referring physician contracts.
Defintely model worst-case scenarios for equipment procurement delays.

If initial capacity utilization falls below 60%, how will we cover the high fixed operating costs?

If initial capacity utilization for your Ultrasound Center falls below 60%, you must immediately freeze non-essential spending and aggressively cut referral commissions to keep cash burn aligned with the $20,800 fixed base operating cost.

Controlling Variable Leaks

Referral commissions are variable costs that scale with volume; they must be targeted first.
If you pay 10% to a primary care group for every scan, low volume means high proportional cost impact.
Renegotiate these agreements down to 7% or shift marketing spend to direct patient acquisition channels.
Focus on increasing scan density within existing referring physician networks rather than chasing new, high-commission partners.

Defending Fixed Overhead

The $20,800 fixed overhead must be defended.
Delay hiring any non-essential staff, especially administrative support, until utilization is consistently above 65%.
If onboarding takes 14+ days, churn risk rises, but hiring too early guarantees you pay salaries when revenue isn't there.
Remember the initial compliance hurdle; Have You Considered The Necessary Licenses And Equipment To Successfully Launch Ultrasound Center? This foundational diligence protects you when volume lags.

Key Takeaways

The initial monthly running cost for an Ultrasound Center is projected to hit $112,000, driven overwhelmingly by specialized payroll, which accounts for 65% of that total.
Founders must secure a minimum working capital buffer of $493,000 to cover operational deficits until the center reaches its cash-flow positive point.
Fixed overhead costs, including essential software (RIS/PACS, EHR) and facility rent, total $20,800 monthly, making capacity utilization the key lever for profitability.
The financial model indicates a 17-month payback period for the initial investment, which is heavily dependent on quickly reaching 60–70% sonographer utilization.

Running Cost 1 : Specialized Payroll & Benefits

Payroll Dominance

Payroll for your 75 full-time employees (FTEs) in 2026 hits $72,708 monthly. This covers sonographers, radiologists, and admin staff. Honestly, this single line item is your biggest operational drain right now. You need tight control over staffing levels.

Staffing Cost Inputs

Estimating this cost requires knowing your required headcount for each role—sonographers, radiologists, and admin. The $72,708 projection assumes 75 FTEs in 2026, including fully loaded costs like taxes and benefits. This number dwarfs the $10,000 facility rent.

Count FTEs per role.
Apply loaded rate.
Factor in 2026 timeline.

Managing Staff Spend

Because payroll is your largest cost, minimizing idle time is crucial. If utilization drops, you're paying a premium for empty chairs. Avoid hiring admin staff too early; use fractional or outsourced support until volume justifies a full-time hire. That’s a quick win.

Monitor utilization daily.
Use part-time sonographers.
Review benefit package costs.

Overhead Comparison

Compared to payroll, other fixed costs look small. Software runs $3,800, and insurance is only $1,200 monthly. If you manage to reduce the staff count by just five FTEs, you defintely save over $4,800 monthly. That savings flow directly to the bottom line.

Running Cost 2 : Facility Rent

Rent Commitment

Facility rent sets a baseline fixed cost of $10,000 monthly for the specialized Ultrasound Center. This expense demands securing a long-term lease immediately to stabilize operations and satisfy lenders or investors. You need this space secured before seeing patients.

Rent Inputs

This $10,000 covers the physical space needed for the diagnostic facility, including exam rooms and administrative areas. To budget this accurately, you need signed quotes for square footage in the target zip code, factoring in tenant improvement allowances if the space needs build-out. It's a key component of your $82,508 in non-payroll fixed overhead.

Input: Location-specific lease rate.
Input: Required square footage.
Input: Lease duration commitment.

Lease Strategy

Avoid signing a short lease; five to seven years is standard for medical facilities to amortize build-out costs. A common mistake is leasing too much space too early; plan for 15% growth capacity but don't pay for empty rooms now. Negotiate free rent periods upfront to offset initial setup expenses. We see defintely better outcomes with longer commitments.

Negotiate rent abatement periods.
Tie escalation clauses to CPI.
Ensure clear exit clauses exist.

Fixed Cost Anchor

Rent is a non-negotiable fixed anchor, meaning revenue must consistently cover this $10,000 monthly obligation regardless of patient volume. If you miss payroll projections, this cost remains due on the first of the month, putting immediate pressure on cash flow management.

Running Cost 3 : Medical Software (RIS/PACS, EHR)

Software Baseline Cost

Your essential medical software stack—RIS/PACS and EHR/Billing—will cost $3,800 per month right out of the gate. This isn't optional; it’s the baseline cost for regulatory compliance and getting paid accurately for every ultrasound service performed.

Essential Software Budget

This $3,800 covers the core digital backbone: the Radiology Information System (RIS), the Picture Archiving and Communication System (PACS), and the Electronic Health Record (EHR) integrated with billing. It’s a fixed monthly fee, unlike supplies. For context, this cost is just $3,800 out of $37,500 in total estimated fixed overhead (excluding payroll). You need quotes based on expected scan volume.

Estimate based on 75 staff volume.
Covers compliance needs.
Must be budgeted monthly.

Managing Software Spend

You can’t skimp on core systems, but watch out for feature creep. Negotiate pricing tiers based on projected patient volume, not current usage. If you start small, ensure the contract allows scaling down easily or migrating later without massive data transfer penalties. Watch out for implementation fees.

Avoid paying for unused modules.
Check data portability clauses.
Lock in multi-year rates carefully.

Operational Linkage

Poor software integration directly impacts your ability to bill quickly, slowing cash conversion cycles. If your EHR doesn't talk to your RIS/PACS smoothly, you’ll see higher administrative costs and defintely risk compliance failures. This directly affects how fast you cover your $10,000 facility rent.

Running Cost 4 : Equipment Service Contracts

Service Contract Cost

Budgeting $2,500 monthly for service contracts on your high-end ultrasound machines is necessary overhead. This spend directly prevents costly unscheduled downtime and keeps your diagnostic image quality high enough to satisfy referring physicians.

Contract Specifics

This $2,500 monthly covers preventative maintenance and emergency repairs for specialized imaging hardware. It’s a fixed operational cost that protects your revenue stream, which otherwise relies on utilization capacity. This is small compared to the $72,708 monthly payroll.

Covers high-end ultrasound units.
Ensures rapid vendor response times.
Guarantees diagnostic quality compliance.

Managing Service Spend

Don't try to save money by opting for lower-tier service agreements; downtime kills patient throughput. Always negotiate response SLAs (Service Level Agreements) upfront. If you have multiple machines, try bundling contracts for better leverage, though savings are usually minimal.

Avoid skipping preventative checks.
Negotiate response time guarantees.
Don't confuse service cost with depreciation.

Downtime Risk

If a machine is down for three days without a contract, the lost revenue easily exceeds the annual service cost. You need to know the Mean Time To Repair (MTTR) vendors promise. If onboarding takes 14+ days, churn risk rises defintely.

Running Cost 5 : Utilities and Office Overhead

Facility Baseline Costs

Your fixed overhead includes essential facility operations adding $2,300 monthly. This covers $1,500 for utilities and $800 for office supplies and cleaning services. This cost is constant regardless of how many ultrasound scans you perform next month.

Cost Breakdown Inputs

This $2,300 expense is a baseline for keeping the physical space operational for staff and patients. It combines variable utility usage with fixed service contracts. You must budget for this amount every month before seeing your first patient.

Utilities estimation: $1,500 monthly
Supplies and cleaning: $800 monthly
Total fixed overhead component: $2,300

Managing Overhead

Since utilities fluctuate, focus on equipment efficiency in your diagnostic center. Negotiate bundled rates for cleaning and supplies to secure better pricing than spot-market rates. Don't pay for cleaning services you defintely don't need.

Benchmark utility spend against similar medical offices.
Lock in supply pricing for 12 months.
Review cleaning scope quarterly.

Overhead Context

This $2,300 is a small but necessary slice of your total fixed costs, which are substantial due to specialized payroll and rent. Compared to the $10,000 rent and $72,708 payroll, this overhead is manageable, but it must be covered before you hit break-even volume.

Running Cost 6 : Insurance (GL/Malpractice)

Insurance Cost Floor

General liability and malpractice insurance is a non-negotiable fixed cost, set at $1,200 monthly for this diagnostic center. This premium mitigates professional risk associated with patient care and facility operations. You can't operate without it.

Budgeting the Premium

This $1,200 monthly premium covers two main areas: General Liability (GL) for premises accidents, and Malpractice for professional negligence in imaging. You estimate this by getting quotes based on expected revenue and staff count, not utilization. It’s a fixed cost, unlike your 20% variable supply expense.

Get quotes based on projected revenue.
Factor in the number of licensed practitioners.
Review coverage limits annually.

Managing Risk Spend

Don't just accept the first quote you see. Shop multiple carriers specializing in medical practice insurance. You might save 10% to 15% by bundling GL and Malpractice policies. A common mistake is underestimating the required policy limits as patient volume grows; that will defintely raise your renewal cost later.

Compare quotes from three brokers minimum.
Ask about claims-made vs. occurrence policies.
Review limits if volume doubles quickly.

Compliance Check

This $1,200 monthly spend is mandatory for facility licensing and credentialing with referring physician groups. If you cannot show proof of adequate coverage, your ability to generate revenue stalls immediately. It’s a cost of doing business in healthcare, period.

Running Cost 7 : Variable Medical Supplies

Supply Cost Ratio

Direct medical supplies like gel and disposables are variable costs tied directly to patient volume. We estimate these costs at 20% of revenue. For 2026 projections, this means supplies will cost about $3,079 monthly, so watch utilization closely.

Inputs for Supplies

This cost covers every item used per procedure: ultrasound gel, sterile probe covers, and patient disposables. To calculate this, multiply projected monthly procedures by the average supply cost per scan. If revenue hits $15,395, supplies will be $3,079. You defintely need firm vendor quotes now.

Track gel usage per scan type
Factor in sterilization costs
Verify unit pricing quarterly

Controlling Supply Spend

Since this is volume-driven, focus on procurement leverage rather than reducing necessary usage. Negotiate tiered pricing based on projected annual volume, not just monthly needs. Avoid overstocking expensive disposables, which ties up working capital. Aim for a 45-day maximum inventory level.

Consolidate purchasing power
Standardize gel brands
Track waste rates per sonographer

Scaling Risk

If patient volume rapidly exceeds the 2026 projection, your purchasing power lags behind the immediate need. This forces expensive, small-batch orders, temporarily pushing the variable cost ratio above 20% until new contracts kick in.