The opening credits have barely finished rolling on the 300th episode of ER when a mysterious doughnut-shaped object with a big red bow attached rolls through the bustling main hall of County General Hospital.

Hospital worker: Admin sent this down.
Frank: Right; park it by Trauma.
Dr. Pratt: What's that?
Frank: New portable CT scanner. Holiday gift for the ER instead of those T-shirts we usually get.
Soon enough, another curious doc sidles over to the machine and pokes his head inside.
Dr. Morris: Man, this CT scan is cool…. Whoa, no-contrast scan in 15 seconds!… How about we fire this baby up?

The device, known as a CereTom, isn't actually "fired up" till Act III of the script, when Dr. Gates, played by John Stamos, studies the CT scan of a head trauma victim and makes a confident diagnosis: "Big subdural; he blew a pupil." As the patient seizes, another look at the scan reveals a circular skull fracture--a perfect opening for draining the patient's bleeding, and for a feat of inspired (and stomach-turning) emergency doctoring that saves his life. In all, the product's name and logo are clearly visible for a full five seconds of airtime.

In the week following the show's airing, on December 6, 2007, the headquarters of NeuroLogica--the Danvers, Massachusetts, company that makes the CereTom--was abuzz. Website traffic was up 60 percent over the previous four weeks' average, driven by users searching for "CereTom." The sales department received 10 direct inquiries from hospital reps who had seen the $330,000 device on ER; typically, it gets two or three such calls per month. Customers called to say they had seen the show and got a boost from being able to tout their cutting-edge equipment. Three medical reporters contacted the company about writing articles. The Oakland Raiders football team, to which NeuroLogica had lent a CereTom for diagnosing on-field injuries, decided to do a "press day" on its scanner to build on the ER buzz. The scanner was discussed on several blogs devoted to ER, including one for medical professionals, and fans of the show posted clips on YouTube, thus guaranteeing online reruns.

The company was thrilled by the surge of interest in its new product. "Although I was on the set for the filming, I was still shocked to see how much exposure we received," says David Webster, NeuroLogica's director of sales. "My friends in the industry were also surprised and could not believe that we did not pay for it."

That's understandable. Though the National Association of Broadcasters has tried to restrict paid product placement on TV, the industry has still grown at an annual rate of about 30 percent, with 2007 spending estimated by research firm PQ Media at $2.9 billion. But the dirty little secret of the industry is that "for over 98 percent of placements, there are no fees paid [to the networks or studios]," says Michael Schrager of The Entertainment Marketing Group, a product placement agency in Santa Monica, California. Big consumer products companies secure prominent placement for things like cell phones and soft drinks as part of larger sponsorship deals or ad buys. Smaller companies are able to avoid paying because the networks assume the size of the deals would not be worth their time. And since they generally don't compete with regular TV advertisers, companies with niche products, like NeuroLogica, actually have a better chance than most of attaining the product placement Holy Grail: name mention and a hands-on role in the story. "You never know when background placement might become a major part of a scene," says Frank Zazza, who is considered the father of modern product placement (he arranged for Reese's Pieces to appear in E.T.) and is the founder and CEO of iTVX, a firm that tracks placements.

Dramatic shows set in crime labs and hospitals--because of their demand for expensive, cutting-edge props--happen to be a particularly accessible venue for companies that are seeking cost-effective exposure for innovative products. "Producers want the newest and best equipment out there to make the shows as realistic as possible," says Tricia Scott, a product coordination specialist who helps feature films and shows such as Grey's Anatomy, Nip/Tuck, and General Hospital acquire medical equipment. Traditional prop houses don't rent state-of-the-art gear, and buying CT scanners, dialysis machines, and heart monitors would blow up most any production budget. Through product placement or product coordination--the term Scott uses for what she does, because she works for the production companies--the shows get the props they need and manufacturers boost brand awareness at no cost beyond the value of the goods they're providing. Especially for a smaller company like NeuroLogica--which had $10 million in revenue in 2007, in an industry dominated by GE, Philips, Siemens, Toshiba, and Hitachi--the credibility conveyed by an appearance on a network drama can be invaluable.

The company teased the ER episode with a mailing to its customers. "We sent something out to our entire customer database saying, for existing customers, 'See your scanner on ER,' and for the customers we're working on, 'See the scanner you're going to get on ER,' " Webster says. "It's a cheap, innovative way to keep people excited."

Breaking into product placement takes a lot of advance work and a little bit of luck. NeuroLogica's ER appearance, for example, came out of the blue: The show's producers discovered the CereTom online and fast-tracked it into the script. But the ER appearance capped a year in which the company and its PR firm, the Racepoint Group in Waltham, Massachusetts, pursued an aggressive product placement strategy. Thanks to their efforts, the CereTom enjoyed fleeting appearances on ABC's hit show Grey's Anatomy and TLC's Diagnosis X. (The producers of Grey's and the Fox series House were taking a look at CereTom story lines when the Writer's Guild of America strike shut down TV production late last year.)

Nor are NeuroLogica's opportunities for product placement limited to medical dramas. The company has also scored notable successes in sports programming, providing CereTom units for major televised events such as the Indianapolis 500 and last year's Floyd Mayweather Jr.--Oscar De La Hoya championship bout in Las Vegas. Doctors at the boxing match using the device discovered a postfight subdural hematoma in one of the boxers on the day's card.

Cop shows provide another rich venue for product placement. Smart Technologies, a Calgary, Alberta, company that makes interactive display technology (think of a high-tech whiteboard), worked with an agency to get its products on CSI. The show used the company's technology in a number of scenarios over several years, often referring to the products by name and displaying Smart Technologies' logo. Now that the company has some experience with product placement, it has been able to negotiate placements on several other shows without an agency's assistance.

Not every company will achieve this level of success, but those that do will enjoy huge exposure in return for very little investment. "For the small person, considering the opportunities, it's like buying the dollar lottery ticket," says Zazza. "You gotta be in it to win it."