Providence Holy Family Hospital — X-ray prices
← Hospital overviewVerified from Providence Holy Family Hospital’s published price file
Includes cash prices, list prices. 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.
12 prices shown.
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| HC SPINE LUMBOSACRAL MIN 4 VIEWS Inpatient & outpatient | 72110 HCPCS | $1,195 | $837 | — | — | |
| HC SPINE LUMBOSACRAL MIN 4 VIEWS Outpatient | 72110 HCPCS | $366 | $256 | — | — | |
| HC XR CHEST 1 VIEW Inpatient & outpatient | 71045 HCPCS | $522 | $365 | — | — | |
| HC XR CHEST 1 VIEW Outpatient | 71045 HCPCS | $177 | $124 | — | — | |
| HC XR CHEST 2 VIEWS Inpatient & outpatient | 71046 HCPCS | $820 | $574 | — | — | |
| HC XR CHEST 2 VIEWS Outpatient | 71046 HCPCS | $177 | $124 | — | — | |
| HC XR CHEST PORTABLE 1 VIEW Inpatient & outpatient | 71045 HCPCS | $522 | $365 | — | — | |
| HC XR CHEST PORTABLE 1 VIEW Outpatient | 71045 HCPCS | $177 | $124 | — | — | |
| HC XR HAND MIN 3 VIEWS Inpatient & outpatient | 73130 HCPCS | $988 | $692 | — | — | |
| HC XR HAND MIN 3 VIEWS Outpatient | 73130 HCPCS | $231 | $162 | — | — | |
| HC XR SHOULDER COMPLETE MIN 2 VIEWS Inpatient & outpatient | 73030 HCPCS | $1,029 | $720 | — | — | |
| HC XR SHOULDER COMPLETE MIN 2 VIEWS Outpatient | 73030 HCPCS | $231 | $162 | — | — |