I wasn't told by the ER staff that an xray would be absolutely required before an MRI could be ordered by my PCP.  I was only told by the ER docs that they could not order MRIs.   It was presented to me as if an xray was optional and not mandatory.  Later I found in the after visit summary notes, that the ER docs wrote that I refused the X-ray!!!! That is not true!  Had I known it was mandatory, I would have gladly had the ER staff complete one.  As it turned out, for my PCP to order the MRI, I had to come back the next day for an xray.  This was a total waste of time and money and was extremely difficult and dangerous for me as I could barely walk, I was in significant pain and the weather conditions were icy, yet I needed to come back to St Luke's a second time for a diagnostic procedure that even the ER doctors didn't feel was absolutely necessary given their initial hypothesis about what was causing the problem.  Apparently, however, an X-ray IS required by the insurance company before an MRI can be ordered.  This was not fully explained!!!!  In the end, after the unnecessary X-ray, my PCP ordered the MRI anyway.  As initially hypothèsized, the problem is likely nerve and muscle related, NOT bone.  The X-ray provided no additional useful info to advance the original hypothesis.  Totally frustrating, time consuming, dangerous and wasteful experience.  
ASLMC ED