Seattle Children's Hospital
SeattleKing CountyChildrens
Both knees X-ray, standing
Quality: not rated by CMSEarliest available date: call (206) 987-2000
What you may pay
- With insurance from an employer or private plan
- $268 to $477
- ASURIS [11913]: Regence Exchange $268 Typical
- BRIDGESPAN HEALTH COMPANY [11906]: Regence Exchange $268 Typical
- PACIFICSOURCE [12245]: First Health PPO $477 Higher than typical
- RURAL CARRIER BENEFIT PLAN [12271]: First Health PPO $477 Higher than typical
- Paying yourself (cash price)
- $497 Higher than typical
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.
| Bill | Who sends it | How likely | Status | Traditional Medicare allows | Private plans (estimate) |
|---|---|---|---|---|---|
| Hospital's fee | The hospital | Expected | Published by the hospital: the prices above | — | — |
| Radiologist | The radiology group | Expected | Billed separately; amount estimated | $9 | $11 to $16 |
| Ordering doctor's visit | Your doctor | Possible | Billed separately; not priced | — | — |
What you’d pay for these bills
You pay about $56 to $57 of about $279 to $285 billed to your plan.
How each bill comes to you
Hospital's fee
- The provider's charge
- $497
- Insurance adjustment
- −$228
- Allowed amount
- $268
- Your plan pays
- $214
- Your coinsurance
- $53.62
- You owe
- $53.62
Radiologist
- The provider's charge
- Not published
- Allowed amount
- $10.81
- Your plan pays
- $8.65
- Your coinsurance
- $2.16
- You owe
- $2.16
- All bills: allowed amounts
- $279
- Your plan pays
- $223
- You owe in all
- $55.78
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.
Seattle Children's Hospital
Request to send
Subject: Estimate request: both knees x-ray, standing at Seattle Children's Hospital Hello, I am planning a both knees x-ray, standing (billing code CPT 73565) at Seattle Children's Hospital. 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.
If you call. Call (206) 987-2000 and ask for the price estimate or patient financial services line. Say: "I'd like a written estimate for my both knees x-ray, standing."
103 published prices, grouped by who each price applies to.
Cash price 1 price
| Price | Part of the bill | Hospital’s description | How it’s set | Setting | Source date |
|---|---|---|---|---|---|
| $497 | Hospital’s fee | Knees Weightbearing Ap | — | Inpatient or outpatient | — |
List price (before discounts) 1 price
| Price | Part of the bill | Hospital’s description | How it’s set | Setting | Source date |
|---|---|---|---|---|---|
| $497 | Hospital’s fee | Knees Weightbearing Ap | — | Inpatient or outpatient | — |
Commercial insurance 98 prices
| Payer | Plan | Price | Part of the bill | Hospital’s description | How it’s set | Setting | Source date |
|---|---|---|---|---|---|---|---|
| ADMINISTRATORS [13102] | First Choice EHN | $397 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| ADMINISTRATORS [13102] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| ADMINISTRATORS [13102] | First Choice PSHVN | $372 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| AETNA [11000] | Aetna PPO | $417 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| ALLEGIANCE [12264] | Cigna PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| ALLIED [13129] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| ALTIUS HEALTH PLAN [12275] | First Health PPO | $477 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| AMERIBEN [11006] | Aetna PPO | $417 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| ASSURANT HEALTH FC [13135] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| ASURIS [11900] | Regence PPO | $412 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| ASURIS [11913] | Regence Exchange | $268 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| BLUECROSS/SHIELD [11902] | Regence PPO | $412 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| BRIDGESPAN HEALTH COMPANY [11906] | Regence Exchange | $268 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| CARPENTERS TRUST [13100] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| CHPW CASCADE [12228] | CHPW Public Option | $273 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| CHRISTIAN BROTHERS [11001] | Aetna PPO | $417 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| CIGNA [12204] | Cigna Narrow Network | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| CIGNA [12204] | Cigna PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| CLARITEV [12299] | Multiplan PPO | $472 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| COASTAL ADMINISTRATIVE [13140] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| COORDINATED CARE [12267] | Coordinated Care Exchange | $372 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| COORDINATED CARE [12267] | Coordinated Care Public Option | $273 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| CORESOURCE [11004] | Aetna PPO | $417 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| COVENTRY FC [13112] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| COVENTRY MHBP [12272] | First Health PPO | $477 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| COVENTRY [12244] | First Health PPO | $477 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| EBMS FC [13144] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| EBMS [11003] | Aetna PPO | $417 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| EBMS [12241] | Multiplan PPO | $472 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| FIRST CHOICE [13399] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| FIRST HEALTH [12210] | First Health PPO | $477 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| GUARDIAN FC [13105] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| HCC MEDICAL [12274] | First Health PPO | $477 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| HEALTH ALLIANCE [12266] | Multiplan PPO | $472 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| HEALTH ALLIANCE [13233] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| HUMANA [12224] | Multiplan PPO | $472 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| ILWU-PMA [13158] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| KAISER [13400] | Kaiser Exchange | $273 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| KAISER [13400] | Kaiser HMO | $323 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| KAISER [13400] | Kaiser PPO | $372 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| KAISER [13401] | Kaiser HMO | $323 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| KEY BENEFIT ADMIN [12276] | Multiplan PPO | $472 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| KPS [13109] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| LEWERMARK [12286] | First Health PPO | $477 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| LOOMIS BENEFITS WEST [13161] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| MEDICAL MUTUAL [12233] | Multiplan PPO | $472 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| MEDISHARE [12287] | First Health PPO | $477 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| MEGA LIFE [13111] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| MERITAIN HEALTH [13229] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| MERITAIN [12251] | Aetna PPO | $417 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| MERITAIN [12251] | Multiplan PPO | $472 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| MODA FC [13219] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| MODA [11009] | Aetna PPO | $417 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| MODA [12842] | Multiplan PPO | $472 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| MOLINA MARKETPLACE [12831] | Molina Exchange | $372 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| MYERS STEVENS & TOOHEY [13169] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| NIPPON LIFE INSURANCE [12232] | Multiplan PPO | $472 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| PACIFIC UNDERWRITERS [13175] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| PACIFICSOURCE [12245] | First Health PPO | $477 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| PEHP [12235] | Multiplan PPO | $472 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| PERSONIFY CONTRACTED [12205] | 6 Degrees Health | $447 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| PERSONIFY FC [13155] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| PERSONIFY [12270] | Cigna PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| PREFERRED ONE [11008] | Aetna PPO | $417 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| PREFERREDONE ADMIN SERVICES [12236] | Multiplan PPO | $472 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| PREMERA [11600] | Premera Exchange | $268 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| PREMERA [11600] | Premera HMO | $338 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| PREMERA [11600] | Premera Narrow Network | $362 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| PREMERA [11600] | Premera PPO | $412 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| PREMERA [11600] | Premera Public Option | $268 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| PRINCIPAL MUTUAL FC [13115] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| PROVIDENCE HEALTH PLAN [12289] | Cigna PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| PROVIDENCE HEALTH PLAN [13181] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| PSEW [13124] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| REGENCE UMP [12263] | Regence UMP | $323 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| REGENCE [11903] | Regence Exchange | $268 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| REGENCE [11903] | Regence PPO | $412 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| REGENCE [11909] | Regence Exchange | $268 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| REHN & ASSOCIATES [13182] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| RURAL CARRIER BENEFIT PLAN [12271] | First Health PPO | $477 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| SELECT HEALTH [12277] | Multiplan PPO | $472 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| SOUND HEALTH AND WELLNESS [13116] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| STARMARK [13103] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| TONGASS TIMBER TRUST [13202] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| TRUSTEED PLANS [13186] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| TRUSTMARK LIFE INSURANCE [13203] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| TUFTS HEALTH PLAN [12279] | Cigna PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| UMR [12246] | United Narrow Network | $372 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| UMR [12246] | United PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| UNITED HEALTHCARE [12201] | United Exchange | $372 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| UNITED HEALTHCARE [12201] | United HMO | $372 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| UNITED HEALTHCARE [12201] | United Narrow Network | $372 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| UNITED HEALTHCARE [12201] | United PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| WEB TPA [11007] | Aetna PPO | $417 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| WELFARE PENSION [13120] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| WSHIP [13121] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| ZENITH AMERICAN SOLUTIONS [13195] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| ZENITH [13123] | First Choice PPO | $422 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
Other government program 1 price
| Payer | Plan | Price | Part of the bill | Hospital’s description | How it’s set | Setting | Source date |
|---|---|---|---|---|---|---|---|
| USFHP [12208] | Pac Med | $204 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
Unknown 2 prices
| Payer | Plan | Price | Part of the bill | Hospital’s description | How it’s set | Setting | Source date |
|---|---|---|---|---|---|---|---|
| COASTAL ADMIN SVCS CONTRACTED [12222] | 6 Degrees Health | $447 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
| UNITED BEHAVIORAL HEALTH [12234] | United Behavioral Health | $437 | Hospital’s fee | Knees Weightbearing Ap | percent of total billed charges | Inpatient or outpatient | — |
Doctors here who do this procedure
No doctor affiliated with Seattle Children's Hospital billed Traditional Medicare for this often enough for CMS to publish it (11 or more patients a year). That doesn’t mean no one here does it. See all doctors and practices for this procedure.
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