Where should I go for an x-ray?

You need an x-ray. Do you go for an x-ray at a hospital, urgent care, or a radiology practice? It’s a tough question and if you are like most people, your knee-jerk reaction would be to go to the radiology department of your local hospital for the procedure…and that decision could cost you more money than necessary. Here’s why.

How much do x-ray cost with insurance?

Insurance companies pay doctors and facilities through negotiated contract rates. The larger the organization, the greater their bargaining power and therefore, the higher their contracted rates for the services they provide.

If you need an x-ray or other radiological procedure, the costs for any given procedure will vary by facility. Typically, procedures will cost more at a hospital than at an independent radiology practice, and the contracted rates will be higher at the hospital as well. This distinction is important, particularly when a deductible comes into play.

Check x-ray costs with your insurer

If your health insurance has a deductible, you are responsible to pay the full amount of that deductible before your insurer pays anything. If you need an x-ray while you still have a remaining deductible to pay, in essence, you will be fully funding that x-ray yourself: the facility will bill your insurance company, the insurer will approve it at the contracted rate, the insurer will apply the contracted rate for the procedure to your deductible, and you will receive a bill for the full contracted rate from the facility for that procedure. The higher the contracted rate, the more you are responsible to pay.

How much do x-ray cost at urgent care?

To ensure the lowest cost for the procedure, you need to do some research first. Ask the doctor who is ordering the procedure to provide you with the procedure code and the diagnosis code for the test.

Call your insurance company, tell them what you are having done (give them all the codes provided) and ask them to tell you what the cost will be if you have the test at the hospital, urgent care, or if you have it at an independent radiology practice (you will have to give them the name of specific locations in order for them to respond). They will confirm the contracted rates at each facility and they will be able to confirm, based on your plan and its deductibles, how much of that fee you will be responsible to pay. You can then factor this financial piece into your decision about where to have the procedure done.

 


 

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