EXECUTIVE SUMMARY
- An imaging bill may include facility charges, radiologist interpretation charges, insurance adjustments and any patient responsibility assigned by your plan.
- Prior authorization, deductibles, copays, coinsurance and network status can all affect what you owe for MRI, CT, ultrasound, mammography or X-ray.
- Self-pay patients can request an estimate in advance and should ask what is included before scheduling an exam.
This imaging bill explained guide can help you understand common charges, insurance steps and payment options before or after your visit. If you have questions about your own balance, ask your insurance plan, your referring physician or Lucent Medical Imaging at 647 W Broadway, Glendale, CA 91204.
Bill Basics *in plain terms*
An imaging bill explained in simple terms starts with one question, who provided each part of your care. A scan involves appointment scheduling, equipment use, technologist time, supplies, image storage and a radiologist report. Your insurance plan may process those pieces under different benefit rules. Lucent Medical Imaging can help you understand the imaging center portion, but your insurer decides covered benefits, applied deductible and final patient responsibility. For a starting point, review our patient cost estimate information before your appointment.
Your statement may show a billed charge, an insurance adjustment, an insurer payment and an amount due from you. The billed charge is not always the amount you personally owe. Insurance contracts often reduce the allowed amount before patient responsibility is calculated. If your plan has a deductible, you may owe more until that deductible is met. If your plan has a copay or coinsurance, that amount may appear after the claim is processed.
What does an imaging bill include? In most cases, it includes the cost of performing the exam and may also include the cost of a physician specialist reading the images. It can also reflect contrast material, additional views or more than one body area when ordered. If something looks different from your estimate, ask for an itemized explanation and compare it with your insurance explanation of benefits.
Keep every bill and explanation of benefits together.
Check the date of service first.
Ask before paying an unclear balance.
- Keep every bill and explanation of benefits together.
- Check the date of service first.
- Ask before paying an unclear balance.
Two Bills *for one scan*
Many patients ask, why two bills for one scan? The usual answer is that imaging has both a technical and professional fee. The technical fee covers the imaging center work, such as the scanner, technologist, exam setup and image transfer. The professional fee covers the radiologist interpretation and written report. Depending on insurance contracts and billing arrangements, these may arrive as separate statements even though you had one appointment.
A technical and professional fee are not duplicate charges for the same work. They describe two different parts of the same diagnostic service. For example, during an MRI, the imaging center performs the scan and prepares the images. A radiologist then reviews the images and sends findings to your referring physician. If your insurance processes each fee separately, you may see two claims, two explanations of benefits or two balances.
If you receive two bills, compare the service date, exam type and provider name before assuming there is an error. You can also review general insurance information for patients to understand how benefits may apply. If the professional fee comes from a radiology group, that group may have its own billing contact. Your physician can explain why the study was ordered, but the insurer explains benefit processing.
Two bills can be normal for one exam.
Each bill should list the same service date.
Ask which charge is technical or professional.
- Two bills can be normal for one exam.
- Each bill should list the same service date.
- Ask which charge is technical or professional.
Questions before you book? We answer them.
Talk to our Glendale team about scheduling, preparation and what your plan covers, before you commit to an appointment.
Insurance Review *before scheduling*
Insurance review is the process of checking whether your plan is active, whether Lucent Medical Imaging is in network and whether the ordered exam requires prior authorization imaging approval. Verification is not a guarantee of payment, because benefits can change and final decisions are made after the claim is reviewed. Still, it helps identify common issues before your visit. You may use our verify insurance form to start that conversation.
Prior authorization imaging means your insurance plan may require clinical review before it agrees the exam is covered under your benefits. This is common for some MRI, CT and advanced imaging exams, but requirements vary by plan and diagnosis. Authorization does not always mean the exam is free. Deductibles, copays and coinsurance may still apply. If authorization is denied or delayed, your referring physician may need to provide more clinical information.
Who gets prior authorization for imaging? The answer depends on your insurance plan, the ordering physician and the imaging center workflow. Some plans require the referring provider to start the request because they have your clinical notes. Imaging centers may help track status once the order is received. Providers can review our authorization process for imaging orders to understand the information usually needed.
Authorization is not the same as payment.
Your plan controls its approval rules.
Clinical notes may be required.
- Authorization is not the same as payment.
- Your plan controls its approval rules.
- Clinical notes may be required.
Cost Estimates *and real balances*
A cost estimate is a best effort based on the information available before the claim is processed. It may use your exam order, insurance eligibility and known plan benefits. The final balance can differ if your plan applies a deductible differently, if your coverage changes or if the ordered exam changes. If contrast, additional views or another body area are added by physician order, the total may also change.
Why is my final imaging bill different from my estimate? The most common reason is that insurance determines the final allowed amount and patient responsibility after the claim is submitted. An estimate may not show recent claims from other offices that affect your deductible. It also may not include a separate radiologist bill if that professional service is billed independently. Ask for clarification before assuming a mistake.
Patients in Glendale, Los Angeles County and nearby areas can request information before an MRI, low dose CT, ultrasound, 3D mammography or digital X-ray appointment. The estimate process is meant to reduce surprises, not replace your insurance plan's official benefit decision. If you are ready to schedule, you can request an appointment online and ask what billing details are available.
Estimates are not final bills.
Coverage can change before the exam.
Ask what the estimate includes.
- Estimates are not final bills.
- Coverage can change before the exam.
- Ask what the estimate includes.
Self Pay *without insurance*
MRI cost without insurance is a common question, but the answer depends on the exact exam, body part, contrast use and whether a radiologist interpretation is included. A knee MRI, brain MRI and breast MRI can involve different protocols and billing details. If you are uninsured, out of network or choosing not to use insurance, ask for the self-pay amount in advance and ask whether there may be any separate professional fee.
Self pay imaging Glendale patients should know that self-pay pricing is generally handled differently from insurance billing. Instead of waiting for a claim decision, the imaging center may provide a direct payment amount for the ordered service. This amount may depend on having a complete physician order. For clarity, ask whether payment is due before the exam, at check-in or after the report is completed.
What should I ask about self-pay imaging? Ask for the exam name, body part, contrast status, included services and payment timing. Also ask whether the estimate includes the radiologist report, because that report is what your referring physician uses to guide care. If you are comparing options around Glendale or nearby Los Angeles communities, compare the same exam type rather than only the general modality name.
Self-pay amounts depend on the ordered exam.
Contrast can affect the total cost.
Ask if interpretation is included.
- Self-pay amounts depend on the ordered exam.
- Contrast can affect the total cost.
- Ask if interpretation is included.
Common Charges *you may see*
Your statement may list terms that are unfamiliar. A facility or technical charge usually relates to performing the exam. A professional charge relates to the radiologist's interpretation. A contrast charge may appear when contrast material is used for certain MRI or CT exams. A screening or diagnostic label may affect insurance rules, especially for mammography. If you need to review available exam types, see our imaging services overview.
Deductible, copay and coinsurance are different forms of patient responsibility. A deductible is the amount you generally pay before insurance begins paying certain covered services. A copay is often a set amount for a visit or service. Coinsurance is usually a percentage of the allowed amount. Your explanation of benefits should show how the insurer calculated each part, including any noncovered portion.
Why do imaging charges vary by exam? Charges vary because exams use different equipment time, protocols, staff support, supplies and interpretation work. A 3 Tesla MRI with and without contrast is not billed the same way as a general X-ray. An ultrasound and a CT scan are different technologies with different billing codes. Your physician decides what exam is medically appropriate for your situation.
Billing terms describe different responsibilities.
Your EOB is not always a bill.
Exam codes affect insurance processing.
- Billing terms describe different responsibilities.
- Your EOB is not always a bill.
- Exam codes affect insurance processing.
After Insurance *claim decisions*
After your exam, a claim may be submitted to your insurance plan. The plan reviews the claim, applies its contract and sends an explanation of benefits. The explanation of benefits is a notice, not always a request for payment. It should show the billed amount, allowed amount, plan payment and patient responsibility. Once that information is received, you may get a statement for any amount your plan says you owe.
If your claim is denied, do not ignore the notice. Denials may happen because authorization was missing, diagnosis information was incomplete, coverage was inactive or the plan requested more documentation. Some denials can be corrected, while others may require an appeal through your insurance plan. Your referring physician may need to provide clinical details. The imaging center can explain what was submitted, but cannot change your plan's medical policy.
How do I pay my imaging bill? Once your statement is ready, follow the payment instructions on the bill or use the center's approved payment options. Lucent Medical Imaging patients can start with the pay my bill page. If you think insurance has not been applied, contact the billing team before paying so the account can be reviewed.
Read denial letters carefully.
Match the EOB to the bill.
Ask about missing insurance information.
- Read denial letters carefully.
- Match the EOB to the bill.
- Ask about missing insurance information.
Getting Help *with questions*
The best first step depends on the question. If you need to know why your physician ordered an exam, contact that physician. If you need to know covered benefits, call your insurance plan. If you need to know what Lucent Medical Imaging billed or whether your insurance information was received, contact the imaging center. You may also review patient visit guidance before an upcoming appointment.
When you call about a bill, have the patient name, date of birth, service date, exam type, insurance card and statement available. Ask one question at a time, such as whether insurance was billed, whether authorization was on file or whether the balance reflects a deductible. If you received two statements, ask which one is the technical fee and which one is the professional fee.
Lucent Medical Imaging serves patients in Glendale, Los Angeles County and surrounding communities from 647 W Broadway, Glendale, CA 91204. For general billing or scheduling questions, call (818) 679-2867. If you are still gathering documents, you can also use our contact page for location and communication details. For individual medical decisions, always follow the guidance of your referring physician.
Have your statement ready when calling.
Write down names and dates.
Ask your physician about medical necessity.
- Have your statement ready when calling.
- Write down names and dates.
- Ask your physician about medical necessity.
Key takeaways
- Two bills may reflect technical and professional services.
- Authorization does not guarantee full payment.
- Estimates can differ from final insurance balances.
- Self-pay patients should ask what is included.
- Your insurer decides benefit application.
Frequently asked questions
This article is general education, not medical advice. Talk with your physician about what is appropriate for your situation.
About the author
Lucent Clinical Team
Board-certified radiologists & imaging technologists
Every article is written and reviewed by the imaging team at our Glendale center, the same radiologists and technologists who read your study and walk you through the scanner room. We write what we find ourselves explaining at the front desk each week: what a scan feels like, what a report actually says, and what a bill is really made of.
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