EvergreenHealth Medical Center

KirklandKing CountyAcute Care Hospitals

Arm CT scan without contrast

Quality: 5 of 5 (CMS overall rating)Earliest available date: call (425) 899-1000

What you may pay

With insurance from an employer or private plan: $137 to $1,689Depends on your plan. Each plan’s price at this hospital:
AMBETTER: KLH Coordinated Care Ambetter $137 Lower than typical
LIFEWISE HEALTH PLANS: KLH PREMERA ALPINE $188 Lower than typical
CIGNA: KLH CIGNA PPO $1,619 Higher than typical
MULTIPLAN $1,689 Higher than typical
The 2 lowest and 2 highest of 28 plans. Find yours in the table below.Typical at 30 hospitals we cover: $307 to $488 (each hospital’s middle plan price, hospital’s fee). Don’t see your plan? Ask your insurer for its rate here.
Paying yourself (cash price): $1,453 TypicalTypical hospital’s fee at 25 hospitals we cover: $693 to $1,561.

These are prices the hospital published, not a quote. With insurance you usually pay part of the rate (your deductible and coinsurance); the estimator on the procedure page works it out. A higher price does not mean better care.

Doctors usually bill separately. At most hospitals these are the hospital’s own charges. The surgeon, radiologist, anesthesiologist or pathologist usually sends a separate bill: ask each of them for an estimate too.

Source: EvergreenHealth Medical Center’s own price file. CareNavIQ last refreshed prices on 2026-11-05.

Next step: ask the hospital for a Good Faith Estimate for this procedure (phone number above).

Bills to expect

A procedure usually brings several bills, each from whoever did that part of your care. Here is what to expect, with what Traditional Medicare allows for each doctor’s part in this area (King County) and an estimate for private plans.

Separate bills for this procedure and their estimated amounts
Bill	Who sends it	How likely	Status	Traditional Medicare allows	Private plans (estimate)
Hospital's feeThe scan: equipment and technologist	The hospital	Expected	Published by the hospital: the prices above	—	—
RadiologistReading the scan and writing the report	The radiology group	Expected	Billed separately; amount estimated	$50	$59 to $90
Ordering doctor's visitThe visit where the CT scan is ordered or the results are explained	Your doctor	Possible	Billed separately; not priced	—	—

What you’d pay for these bills

Adds up your share of the hospital’s bill and the expected doctors’ bills above (not the possible ones). What you type stays in your browser.

Your coverage Insurance from an employer or a private plan Traditional Medicare Medicare Advantage Apple Health (Medicaid)

Your plan’s price at this hospitalDeductible you still have to pay this yearYour coinsurance after the deductibleOut-of-pocket maximum you have left this year (optional)

Your plan’s summary of benefits says how it charges for each kind of care. Leave these as they are if it uses the deductible and coinsurance.

The hospital's billHow your plan charges

The bill from the doctor doing the procedureHow your plan charges

You pay about $39 to $45 of about $196 to $227 billed to your plan.

Your share of the hospital's bill is about $27; the rest is your share of the doctors' bills. The doctors' bills are estimates. Enter your out-of-pocket maximum to see whether you'd reach it. Assumes everyone is in your network.

How each bill comes to you

Each provider sends a claim to your plan. It applies its allowed amount, then your deductible, copay and coinsurance, and sends you an Explanation of Benefits. Then the provider bills you the “You owe” line. Bills are in the order your plan is assumed to process them, the hospital first. The doctors' bills are estimates.

Show the bills at the lower estimate the higher estimate

Hospital's feeSent by the hospital
The provider's charge
$1,816
Insurance adjustmentWritten off by the provider: you don't owe it.
−$1,679
Allowed amountWhat the insurer counts for this bill.
$137
Your plan pays
$110
Your coinsurance
$27.38
You oweThe provider bills you this after the insurer pays.
$27.38
RadiologistSent by the radiology group
The provider's chargeDoctors don't publish their charges; in network it doesn't change what you owe.
Not published
Allowed amountWhat the insurer counts for this bill.
$59.41
Your plan pays
$47.53
Your coinsurance
$11.88
You oweThe provider bills you this after the insurer pays.
$11.88

All bills: allowed amounts: $196
Your plan pays: $157
You owe in all: $39.26

Who owes what, and when you might owe more

The insurance adjustment Written off
An in-network provider agrees to accept your plan's allowed amount. The difference between its charge and that amount is written off: you don't owe it, and it shouldn't appear on your bill.
Deductible You pay
What you pay each year before your plan starts sharing costs. It is applied to bills in the order your plan processes them, so the first bill can take all of it.
Copay You pay
A fixed amount for a kind of care, such as a hospital stay or a surgeon's visit. Your plan's summary of benefits says whether it applies before or after the deductible, and whether a stay's copay is per day.
Coinsurance You pay
Your percentage of the allowed amount after the deductible, such as 20%.
Out-of-pocket maximum Your plan pays
Once your deductible, copays and coinsurance for the year reach it, your plan pays 100% of covered in-network care for the rest of the plan year.
Each provider bills separately You pay
The hospital, surgeon, anesthesia group, radiologist and pathologist each send their own claim and their own bill. All of them count toward the same deductible and yearly maximum.
Out of network and surprise bills It depends
A provider outside your plan's network can bill you the difference between its charge and what your plan pays (a balance bill). It can't for emergency care, or when anesthesia, radiology, pathology, an assistant surgeon or a hospital doctor treats you at an in-network hospital: under federal law (the No Surprises Act) and, for Washington-regulated plans and self-funded plans that opt in, RCW 48.49, those groups cannot balance bill you. Your deductible and coinsurance still apply, at in-network amounts.
Not covered, or no prior authorization It depends
If your plan decides a service isn't covered, or it needed prior authorization that wasn't approved, the plan pays nothing for it and the provider may bill you. Ask the provider to get prior authorization before your care. If an in-network provider didn't get it, the provider's contract may stop it billing you: ask your plan before you pay.
A second insurance It depends
If you have a second plan, the first plan pays first and the second may then pay some or all of your share. These estimates use one plan only.
Wait for the Explanation of Benefits You pay
After each claim your insurer sends an Explanation of Benefits (EOB) with the allowed amount, what it paid and what you may owe. It is not a bill. Pay a provider's bill only when it matches the EOB's “you may owe” amount, and ask the provider or insurer about any difference.
Help from the hospital It depends
Washington hospitals must give free or discounted care based on income, including deductibles and coinsurance for insured patients: free up to 200% or 300% of the federal poverty level depending on the hospital, with discounts above that (RCW 70.170). You can apply after you get a bill. It covers the hospital's bill; doctor groups that bill separately have their own policies.
If you pay yourself instead You pay
You can choose not to use your insurance and pay the cash price; then nothing counts toward your deductible. Ask each provider for a Good Faith Estimate. If a bill is $400 or more above it, you can dispute it within 120 days.

Get it confirmed before your care

The hospital, each doctor’s group and your insurer can each confirm their part in writing. Here is a request for each one, ready to send from your own email, and what to say if you’d rather call. Nothing you do here is saved.

Coming: CareNavIQ will be able to send these for you, follow up, and tell you when everything is confirmed, with your permission.

How you’ll payWith insurancePaying myself, without insurance

EvergreenHealth Medical Center

The largest bill.

Request to send

Subject: Estimate request: arm ct scan without contrast at EvergreenHealth Medical Center

Hello,

I am planning a arm ct scan without contrast (billing code CPT 73200) at EvergreenHealth Medical Center.

Under Washington law (RCW 70.01.030), I am asking for a written estimate of the hospital's charges, with the billing codes you plan to use.

Name: [YOUR NAME]
Date of birth: [DATE OF BIRTH]
Insurance: [PLAN NAME], member ID [MEMBER ID]
Planned date: [DATE, IF KNOWN]

Thank you.

Replace the words in [brackets] with your details before you send it.

Open in my email

If you call. Call (425) 899-1000 and ask for the price estimate or patient financial services line. Say: "I'd like a written estimate for my arm ct scan without contrast."

I’ve sent this one

0 of 3 sent. Washington law gives you the right to these estimates but sets no deadline: if you haven't heard back in five business days, send it again or call.

How these are worked out. Medicare amounts are CMS’s 2026 physician fee schedule for this area, at the rate for care in a hospital. Private-plan estimates are 118% to 179% of Medicare for doctors (the range across 19 studies in KFF’s review of what private insurers pay) and 3 to 5 times Medicare for anesthesia (a published industry estimate). Anesthesia is paid by the minute, so its range assumes the time shown. Medicare pays an assistant at surgery 13.6% to 16% of the surgeon’s fee. Where we have your insurer’s own published rates for the doctors here (below), the estimator uses those for that insurer’s employer plans instead. Your plan’s own rates may be outside these ranges: ask each office for an estimate, and for its network status. At an in-network hospital, the anesthesia, radiology, pathology and assistant groups can’t charge you more than your in-network cost share, even if they are out of network (No Surprises Act).

74 published prices, grouped by who each price applies to.

Cash price 2 prices

The hospital's discounted price for patients paying without insurance.

Cash price prices for Arm CT scan without contrast at EvergreenHealth Medical Center
Price	Part of the bill	Hospital’s description	How it’s set	Setting	Source date
$1,453	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	—	Inpatient or outpatient	—
$1,453	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	—	Inpatient or outpatient	—

List price (before discounts) 2 prices

The hospital's full chargemaster price. Few patients pay this amount.

List price (before discounts) prices for Arm CT scan without contrast at EvergreenHealth Medical Center
Price	Part of the bill	Hospital’s description	How it’s set	Setting	Source date
$1,816	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	—	Inpatient or outpatient	—
$1,816	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	—	Inpatient or outpatient	—

Commercial insurance 56 prices

Rate negotiated with a private insurer or employer plan, including exchange and public-option plans.

Commercial insurance prices for Arm CT scan without contrast at EvergreenHealth Medical Center
Payer	Plan	Price	Part of the bill	Hospital’s description	How it’s set	Setting	Source date
AETNA	KLH Aetna PPO	$315	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	case rate	Inpatient or outpatient	—
AETNA	KLH Aetna PPO	$315	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	case rate	Inpatient or outpatient	—
ALLIED BENEFIT SYSTEMS	KLH Aetna PPO	$315	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	case rate	Inpatient or outpatient	—
ALLIED BENEFIT SYSTEMS	KLH Aetna PPO	$315	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	case rate	Inpatient or outpatient	—
AMBETTER	KLH Coordinated Care Ambetter	$137	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	other	Inpatient or outpatient	—
AMBETTER	KLH Coordinated Care Ambetter	$137	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	other	Inpatient or outpatient	—
ASURIS	KLH Regence PPO	$285	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	fee schedule	Inpatient or outpatient	—
ASURIS	KLH Regence PPO	$285	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	fee schedule	Inpatient or outpatient	—
BRIDGESPAN	KLH Regence PPO	$285	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	fee schedule	Inpatient or outpatient	—
BRIDGESPAN	KLH Regence PPO	$285	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	fee schedule	Inpatient or outpatient	—
CIGNA	KLH CIGNA PPO	$1,619	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	per diem	Inpatient or outpatient	—
CIGNA	KLH CIGNA PPO	$1,619	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	per diem	Inpatient or outpatient	—
COASTAL ADMINISTRATIVE SERVICES	PHCS 6 DEGREES	$1,544	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	percent of total billed charges	Inpatient or outpatient	—
COASTAL ADMINISTRATIVE SERVICES	PHCS 6 DEGREES	$1,544	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	percent of total billed charges	Inpatient or outpatient	—
FCHN EVERGREEN HC FIRST CHOICE HLTH ADMN	KLH First Choice Domestic	$581	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	percent of total billed charges	Inpatient or outpatient	—
FCHN EVERGREEN HC FIRST CHOICE HLTH ADMN	KLH First Choice Domestic	$581	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	percent of total billed charges	Inpatient or outpatient	—
FEDERAL EMPLOYEES PROGRAM ALTERNATE PAYOR	KLH Premera PPO	$307	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	other	Inpatient or outpatient	—
FEDERAL EMPLOYEES PROGRAM ALTERNATE PAYOR	KLH Premera PPO	$307	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	other	Inpatient or outpatient	—
FIRST CHOICE	KLH First Choice Domestic	$581	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	percent of total billed charges	Inpatient or outpatient	—
FIRST CHOICE	KLH First Choice Domestic	$581	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	percent of total billed charges	Inpatient or outpatient	—
FIRST CHOICE	KLH First Choice PPO	$427	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	fee schedule	Inpatient or outpatient	—
FIRST CHOICE	KLH First Choice PPO	$427	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	fee schedule	Inpatient or outpatient	—
FIRST HEALTH	KLH Aetna PPO	$315	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	case rate	Inpatient or outpatient	—
FIRST HEALTH	KLH Aetna PPO	$315	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	case rate	Inpatient or outpatient	—
KAISER PERMANENTE	KLH KAISER PPO	$339	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	other	Inpatient or outpatient	—
KAISER PERMANENTE	KLH KAISER PPO	$339	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	other	Inpatient or outpatient	—
LIFEWISE HEALTH PLANS	KLH PREMERA ALPINE	$188	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	other	Inpatient or outpatient	—
LIFEWISE HEALTH PLANS	KLH PREMERA ALPINE	$188	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	other	Inpatient or outpatient	—
LIFEWISE HEALTH PLANS	KLH Premera PPO	$307	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	other	Inpatient or outpatient	—
LIFEWISE HEALTH PLANS	KLH Premera PPO	$307	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	other	Inpatient or outpatient	—
MERITAIN	KLH Aetna PPO	$315	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	case rate	Inpatient or outpatient	—
MERITAIN	KLH Aetna PPO	$315	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	case rate	Inpatient or outpatient	—
MOLINA MARKETPLACE	KLH Molina Marketplace	$214	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	other	Inpatient or outpatient	—
MOLINA MARKETPLACE	KLH Molina Marketplace	$214	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	other	Inpatient or outpatient	—
MULTIPLAN	MULTIPLAN	$1,689	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	percent of total billed charges	Inpatient or outpatient	—
MULTIPLAN	MULTIPLAN	$1,689	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	percent of total billed charges	Inpatient or outpatient	—
PHCS	KLH Private Healthcare System	$1,544	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	percent of total billed charges	Inpatient or outpatient	—
PHCS	KLH Private Healthcare System	$1,544	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	percent of total billed charges	Inpatient or outpatient	—
PHCS	PHCS 6 DEGREES	$1,544	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	percent of total billed charges	Inpatient or outpatient	—
PHCS	PHCS 6 DEGREES	$1,544	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	percent of total billed charges	Inpatient or outpatient	—
PREMERA BLUE CROSS	KLH PREMERA HERITAGE PRIME	$287	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	other	Inpatient or outpatient	—
PREMERA BLUE CROSS	KLH PREMERA HERITAGE PRIME	$287	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	other	Inpatient or outpatient	—
PREMERA BLUE CROSS	KLH Premera Exchange	$290	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	other	Inpatient or outpatient	—
PREMERA BLUE CROSS	KLH Premera Exchange	$290	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	other	Inpatient or outpatient	—
PREMERA BLUE CROSS	KLH Premera PPO	$307	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	other	Inpatient or outpatient	—
PREMERA BLUE CROSS	KLH Premera PPO	$307	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	other	Inpatient or outpatient	—
REGENCE BLUE SHIELD	KLH REGENCE INDIVIDUAL AND FAMILY	$256	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	fee schedule	Inpatient or outpatient	—
REGENCE BLUE SHIELD	KLH REGENCE INDIVIDUAL AND FAMILY	$256	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	fee schedule	Inpatient or outpatient	—
REGENCE BLUE SHIELD	KLH Regence PPO	$285	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	fee schedule	Inpatient or outpatient	—
REGENCE BLUE SHIELD	KLH Regence PPO	$285	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	fee schedule	Inpatient or outpatient	—
REGENCE BLUE SHIELD	KLH UMP	$278	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	fee schedule	Inpatient or outpatient	—
REGENCE BLUE SHIELD	KLH UMP	$278	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	fee schedule	Inpatient or outpatient	—
REGENCE BLUE SHIELD ALTERNATE	KLH Regence PPO	$285	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	fee schedule	Inpatient or outpatient	—
REGENCE BLUE SHIELD ALTERNATE	KLH Regence PPO	$285	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	fee schedule	Inpatient or outpatient	—
UNITED HEALTHCARE	KLH UHC PPO	$315	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	case rate	Inpatient or outpatient	—
UNITED HEALTHCARE	KLH UHC PPO	$315	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	case rate	Inpatient or outpatient	—

Medicare Advantage 10 prices

Rate for a private Medicare Advantage plan. Applies only to members of that plan.

Medicare Advantage prices for Arm CT scan without contrast at EvergreenHealth Medical Center
Payer	Plan	Price	Part of the bill	Hospital’s description	How it’s set	Setting	Source date
AARP	KLH 103% of Medicare	$123	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	other	Inpatient or outpatient	—
AARP	KLH 103% of Medicare	$123	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	other	Inpatient or outpatient	—
AETNA MEDICARE ADVANTAGE	KLH 103% of Medicare	$123	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	other	Inpatient or outpatient	—
AETNA MEDICARE ADVANTAGE	KLH 103% of Medicare	$123	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	other	Inpatient or outpatient	—
PREMERA BLUE CROSS MEDICARE ADVANTAGE	KLH 105% OF MEDICARE - PREMERA MED ADVANTAGE	$125	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	other	Inpatient or outpatient	—
PREMERA BLUE CROSS MEDICARE ADVANTAGE	KLH 105% OF MEDICARE - PREMERA MED ADVANTAGE	$125	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	other	Inpatient or outpatient	—
REGENCE MEDICARE ADVANTAGE	KLH 103.5% of Medicare	$123	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	other	Inpatient or outpatient	—
REGENCE MEDICARE ADVANTAGE	KLH 103.5% of Medicare	$123	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	other	Inpatient or outpatient	—
UNITED HEALTHCARE MEDICARE ADVANTAGE	KLH 103% of Medicare	$123	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	other	Inpatient or outpatient	—
UNITED HEALTHCARE MEDICARE ADVANTAGE	KLH 103% of Medicare	$123	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	other	Inpatient or outpatient	—

Other government program 2 prices

TRICARE, VA, Indian Health Service, workers' compensation, or another public program.

Other government program prices for Arm CT scan without contrast at EvergreenHealth Medical Center
Payer	Plan	Price	Part of the bill	Hospital’s description	How it’s set	Setting	Source date
TRICARE	KLH TriCare/CHAMPUS	$122	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	other	Inpatient or outpatient	—
TRICARE	KLH TriCare/CHAMPUS	$122	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	other	Inpatient or outpatient	—

Unknown 2 prices

The source file doesn't say which population this rate applies to.

Unknown prices for Arm CT scan without contrast at EvergreenHealth Medical Center
Payer	Plan	Price	Part of the bill	Hospital’s description	How it’s set	Setting	Source date
HUMANA	KLH HUMANA	$1,634	Hospital’s fee	HC CT Scan Upper Extremity W/WO Dye - CT W/WO IV Contrast	percent of total billed charges	Inpatient or outpatient	—
HUMANA	KLH HUMANA	$1,634	Hospital’s fee	HC CT Scan Upper Extremity W/O Dye - CT Upper Ext WO IV Contrast	percent of total billed charges	Inpatient or outpatient	—

Doctors here who do this procedure

1 doctor affiliated with EvergreenHealth Medical Center billed Traditional Medicare for Arm CT scan without contrast in 2024, most Medicare services first. See all doctors and practices, including those with no hospital affiliation.

Doctors affiliated with EvergreenHealth Medical Center who billed Traditional Medicare for Arm CT scan without contrast
Doctor or practice	Practice	Medicare quality score	Times billed to Traditional Medicare (2024)	Traditional Medicare amount for their own service (2024)
Philip Lowe, MDDiagnostic Radiology · Lynnwood	Swedish Health ServicesGroup of 1,037 clinicians	Not rated	38	$48.25 at a hospital or surgery center

Reading the doctor list

A higher price doesn’t mean better care. The quality score and the price come from different CMS files and are shown separately on purpose.
The amount is what Traditional Medicare (original Medicare) approved for the doctor’s or lab’s own service: Medicare’s payment plus the patient’s share. It is not what commercial insurance or Medicare Advantage pays, and the hospital or surgery center bills separately (surgery centers aren’t in this list).
The Medicare quality score is CMS’s MIPS final score (0 to 100), based mostly on the doctor’s Medicare patients. About half of doctors aren’t scored, so Not rated says nothing bad about a doctor. A group’s score covers everyone in the group.
CMS doesn’t publish counts under 11 patients, so doctors who rarely bill Medicare for this aren’t listed, and No price published means CMS has no amount for that setting.
Medicare’s file doesn’t say where a doctor did the procedure, only that they billed it in Washington. Affiliations are the hospitals each doctor lists with Medicare.

See a price that looks wrong? Tell us about it.

EvergreenHealth Medical Center

What you may pay

Bills to expect

What you’d pay for these bills

How each bill comes to you

1 Hospital's feeSent by the hospital

2 RadiologistSent by the radiology group

Get it confirmed before your care

EvergreenHealth Medical Center

Cash price 2 prices

List price (before discounts) 2 prices

Commercial insurance 56 prices

Medicare Advantage 10 prices

Other government program 2 prices

Unknown 2 prices

Doctors here who do this procedure

Reading the doctor list

Hospital's feeSent by the hospital

RadiologistSent by the radiology group