You can get a chest x-ray for tuberculosis at local health department clinics, community health centers, urgent care facilities, hospital imaging centers, and private radiology labs. Your best starting point depends on whether you have insurance, need the x-ray for work or school clearance, or are following up on a positive TB test.
Local Health Department Clinics
County and city health departments are the most common place people go for TB-related chest x-rays, and they’re often the most affordable option. Many public health TB programs provide screening, x-rays, medical evaluation, and treatment at no cost regardless of income. In cities like New York, dedicated Health Department Chest Centers offer free TB evaluation that includes skin or blood testing, chest x-rays, and treatment for both active TB disease and latent infection. Shelby County, Tennessee runs a similar program, with physicians specializing in infectious disease and pulmonology who review x-ray results, develop treatment plans, and follow patients through completion of therapy.
To find your local TB clinic, search your county or state health department website, or call 211 (a nationwide referral line). Most health departments accept walk-ins or same-day appointments for TB services, though hours can be limited. You typically don’t need a doctor’s referral to get screened at a public health clinic.
Urgent Care and Retail Health Clinics
Many urgent care centers have on-site x-ray equipment and can perform a TB chest x-ray during a single visit. This is a practical option if your local health department has limited hours or long wait times. Expect to pay a visit fee plus an imaging fee, which together typically range from $100 to $250 without insurance. Some retail health clinics inside pharmacies can order chest x-rays but may send you to a partner imaging facility nearby.
Hospital Imaging Centers and Private Radiology Labs
If your doctor orders a chest x-ray after a positive TB test, you’ll likely be sent to a hospital outpatient imaging department or a freestanding radiology center. These facilities generally require a physician’s order before they’ll perform the x-ray. The upside is that results are sent directly to your ordering physician, who can then coordinate next steps. Private radiology labs tend to cost more than public health clinics but are widely available and often have flexible scheduling.
Your Primary Care Doctor’s Office
Some primary care offices have x-ray equipment on-site and can handle the entire process, from the initial TB blood test to the chest x-ray to the follow-up visit, in one location. If your doctor’s office doesn’t have imaging capabilities, they’ll write an order and refer you to a nearby facility. This route works well if you already have an established provider and insurance coverage.
Do You Need a Referral or Doctor’s Order?
It depends on where you go. Public health department TB clinics generally do not require a referral. You can walk in, get tested, and receive an x-ray as part of their standard screening process. Private imaging centers and hospital radiology departments almost always require a written order from a physician. Urgent care centers can both evaluate you and order the x-ray during the same visit, effectively acting as a one-stop option.
One important exception: if you’re going through the immigration medical exam process, the CDC requires that civil surgeons order chest x-rays independently and not refer applicants to health departments for imaging. If you’re completing an immigration physical, your designated civil surgeon will handle the x-ray order directly.
When a Chest X-Ray Is Actually Needed
Not everyone screened for TB needs a chest x-ray. The standard process starts with either a skin test (PPD) or a blood test (IGRA). A chest x-ray comes into play only if one of those initial tests is positive. For healthcare workers, the CDC recommends a two-step process: if the first test is positive but the person is considered low risk, a second test is given. A chest x-ray is ordered only when both tests come back positive, or when the person is at higher risk for TB exposure.
If you’ve had a documented positive TB test in the past, you’ll need a chest x-ray or proof of a previous normal x-ray when starting a new healthcare job or enrolling in certain schools. However, repeat chest x-rays aren’t required after that unless you develop new symptoms like a persistent cough, fever, night sweats, or unexplained weight loss.
What to Bring to Your Appointment
Bring any documentation of your positive TB skin test or blood test result, including the date it was performed and the reading. If you’re getting the x-ray for employment or school, bring the specific form your employer or institution requires, as many have their own paperwork that the provider needs to fill out. A photo ID, your insurance card (if applicable), and any records of previous TB testing or chest x-rays will help the visit go smoothly. If you’ve had a prior positive test and a normal x-ray in the past, bring that documentation since it may eliminate the need for a new image.
What Happens With Your Results
A chest x-ray itself takes only a few minutes. You’ll stand against the imaging plate, take a deep breath, and hold still for a brief exposure. The actual imaging is painless and quick.
Turnaround time for results varies by facility. At a public health TB clinic, a physician on staff often reviews the x-ray the same day and can discuss findings with you immediately. At a private radiology center or hospital, a radiologist reads the image and sends a report to your ordering physician. This typically takes one to three business days, though some facilities offer same-day preliminary reads.
A normal chest x-ray with a positive skin or blood test usually means you have latent TB infection, meaning bacteria are present but not causing illness and you’re not contagious. Your provider will discuss whether preventive treatment makes sense. If the x-ray shows abnormalities like areas of consolidation or certain nodule patterns, further evaluation with sputum samples and possibly a CT scan will follow to determine whether you have active TB disease.
Cost Without Insurance
Public health department clinics are your best bet for free or very low-cost TB chest x-rays. Many TB control programs are funded specifically to provide services regardless of ability to pay. At urgent care, expect to spend $100 to $250 out of pocket for the visit and x-ray combined. Hospital outpatient imaging departments tend to charge more, sometimes $200 to $400 for an uninsured patient, though many offer financial assistance programs. If cost is a barrier, call your county health department first, as TB services are among the most consistently subsidized public health offerings in the U.S.