In most cases, getting a chest x-ray starts with a doctor’s order. You can’t typically walk into an imaging center and request one yourself. A physician, nurse practitioner, or physician assistant evaluates your symptoms, determines that imaging is warranted, and writes a referral or order that you then take to a radiology facility. The entire process, from the moment you check in to the moment you leave, usually takes less than 15 minutes.
Why a Doctor’s Order Is Required
Chest x-rays use ionizing radiation, and medical imaging facilities are required to have a valid order from a licensed provider before performing one. This isn’t just a bureaucratic hurdle. The referring provider needs to confirm there’s a clinical reason for the scan so the radiologist knows what to look for when reading it. “Routine” chest x-rays without a specific symptom or clinical question are no longer standard practice. Guidelines from the American College of Radiology note that preoperative or admission chest x-rays aren’t warranted for patients without respiratory symptoms, with exceptions for older adults, immunocompromised patients, or people with implanted cardiac devices like pacemakers.
Common reasons a provider will order a chest x-ray include persistent cough, shortness of breath, chest pain, suspected pneumonia, monitoring a known lung condition, or checking for fluid around the lungs or heart. If you’re experiencing any of these, your primary care provider or an urgent care clinic can write the order during a standard visit.
Where to Get One
Once you have an order, you have several options for where to go:
- Hospital radiology departments handle the highest volume but tend to be the most expensive option and may have longer wait times.
- Freestanding imaging centers are independent facilities that often offer lower prices and faster scheduling, sometimes with same-day availability.
- Urgent care clinics frequently have x-ray equipment on-site, meaning you can get the order and the image in a single visit.
- Mobile x-ray services send technicians with portable equipment to nursing homes, assisted living facilities, or private residences for patients who are homebound. These companies operate in most states. In Indiana alone, for example, over a dozen licensed portable x-ray providers serve various regions.
If cost is a concern, call ahead and ask for the self-pay or cash price. Freestanding imaging centers are almost always cheaper than hospital-based radiology departments for the same scan.
What It Costs
Without insurance, a chest x-ray at an imaging center typically runs between $100 and $300. Hospital-based facilities charge more, often $200 to $500 for the same study. With insurance, your out-of-pocket cost depends on your plan’s copay and whether you’ve met your deductible. If you have a high-deductible plan, you may pay the full amount until that threshold is reached.
Some tips to reduce cost: ask the facility for their cash-pay rate (it’s often lower than the “list” price billed to insurance), compare prices between nearby imaging centers, and check whether your insurance requires you to use a specific in-network facility.
How to Prepare
Chest x-rays require almost no preparation. There’s no fasting, no contrast dye to drink, and no IV. The main thing to think about is clothing. Wear a plain t-shirt or top without zips, buttons, or metal snaps. You’ll be asked to remove necklaces, and women will need to remove their bra and change into a gown, since underwire and clasps show up on the image and can obscure important details. Leave jewelry at home if you can.
If you’re pregnant or think you might be, tell the technologist before the scan. That said, the radiation dose from a single chest x-ray is extremely low: about 0.1 millisieverts, which is roughly equivalent to one day of natural background radiation. The CDC notes that diagnostic imaging at this dose level is not likely to cause health effects for a fetus, since the threshold for detectable harm is around 100 millisieverts, or about 1,000 times the dose of a single chest x-ray.
What Happens During the Scan
The standard chest x-ray is taken with you standing upright, facing a flat detector panel. Your hands go on your hips or wrap around the sides of the panel to rotate your shoulder blades out of the way so they don’t overlap your lungs in the image. The x-ray beam passes through your back and exits through your chest. This is called a PA (posterior-to-anterior) view and is the default for anyone who can stand.
If you’re too ill to stand, the technologist will take the image while you’re sitting or lying down, with the beam traveling from front to back instead. This AP (anterior-to-posterior) view magnifies the heart slightly, which radiologists account for when reading the image. Your provider may also order a lateral (side) view to get a second angle, particularly if they’re looking at structures behind the heart or in the lower lobes of the lungs.
You’ll be asked to take a deep breath and hold it for a few seconds while the image is captured. The actual exposure lasts a fraction of a second. The whole process, positioning included, takes about five minutes.
How Long Results Take
Turnaround time depends on the clinical setting. If you’re in an emergency department, a radiologist will typically read the image within 4 to 12 hours. For urgent referrals from a primary care provider, reports are usually available within a few days to a week. Routine outpatient x-rays can take up to a few weeks to be formally reported, though many facilities are faster than that.
In practice, your doctor’s office will contact you once the radiologist’s report is in, or you may be able to see results through an online patient portal. If you haven’t heard anything after a week for a non-urgent scan, it’s reasonable to call and ask.
Getting a Chest X-Ray Without a Primary Care Doctor
If you don’t have an established primary care provider, urgent care is the most straightforward path. Walk-in clinics can evaluate your symptoms, order the x-ray on the spot (if the facility has imaging equipment), and review the results with you the same day. Some telehealth services can also write imaging orders after a virtual visit, though you’ll still need to go to a physical location for the actual scan.
A small number of direct-access imaging centers in certain states allow patients to self-refer for x-rays without a physician order, but this is uncommon and varies by state law. In most of the U.S., a provider’s order remains a requirement.