AdventHealth Polk — X-ray prices
← Hospital overviewVerified from AdventHealth Polk’s published price file
Includes list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
6 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| HC CAH II RADIOLOGIC EXAM CHEST SINGLE VIEW Inpatient & outpatient | 71045 HCPCS | $348 | — | — | — | |
| HC RADIOLOGIC EXAM CHEST 2 VIEWS Inpatient & outpatient | 71046 HCPCS | $371 | — | — | — | |
| HC RADIOLOGIC EXAM CHEST SINGLE VIEW Inpatient & outpatient | 71045 HCPCS | $348 | — | — | — | |
| HC X-RAY HAND 3+ VW Inpatient & outpatient | 73130 HCPCS | $346 | — | — | — | |
| HC X-RAY LUMBAR SPINE 4 VW Inpatient & outpatient | 72110 HCPCS | $740 | — | — | — | |
| HC X-RAY SHOULDER 2+ VW Inpatient & outpatient | 73030 HCPCS | $412 | — | — | — |