What a knee X-ray actually costs
Cheap to perform and routinely the opening charge in a much longer orthopedic bill.
List price
$802
What the hospital lists the procedure at.
Cash price
$266
What the hospital charges someone paying without insurance.
Cash is
33%
of the list price. The self-pay discount, as published.
What different people pay
| The list priceWhat the hospital publishes as its gross charge | $802 |
| Paying without insuranceThe hospital's own discounted cash price | $266 |
| An insurer with a contractMedian of the rates hospitals publish per payer and plan | $112 |
Read that again: paying cash costs 2.4x what an insurer pays for the same procedure at the same hospitals. The cash discount is real, and it still leaves you paying more than any contracted payer.
The gap is the argument
A list price is close to fiction. Almost nobody pays it: Medicare does not, no insurer with a contract does, and the hospital itself will take far less from someone paying cash. It is an opening number.
If your bill for knee x-ray is near the list price, the figures above are what you raise. Ask for the cash price by name, it is published and they are required to honour it. Then ask why you are being charged more than a contracted payer for identical work.
What these numbers are not: a quote. Prices vary by hospital, by region and by what else happens during the visit. These are medians of what hospitals published, not an average of what people were billed.
One operation produces several separate bills from several separate businesses, and they arrive weeks apart. That fragmentation is where the errors hide.
You got a surgery billWhere this came from
Prices published by 30 hospitals in their machine-readable files under 45 CFR 180.50, 101 of which listed a cash price for this procedure. Those hospitals are all part of one health system, so treat these as that system's published prices rather than a national average. Retrieved 2026-08-07.