Upper GI X-ray with contrast dye

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

Single contrast X-ray of upper digestive tract

Payers reporting CPT 74240

Payer pricing summary

Low

$85

Average

$400

Median

$372

High

$1.2k

Payer rate distribution

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#
1	Anthem fee schedule · outpatient · +34 other terms	204	$268	$227	$220	97%	205–511	$4 – $1.7k
2	Medicare other · both · +22 other terms	50	$186	$216	$110	51%	193–499	$163 – $871
3	Molina fee schedule · outpatient · +35 other terms	264	$184	$182	$93	51%	76–211	$1 – $845
4	Bcbs Al facility · other · outpatient · +4 other terms	6	$175	$182	$13	7%	74–155	$159 – $208
5	UnitedHealthcare fee schedule · outpatient · +40 other terms	807	$292	$298	$218	73%	71–224	$1 – $5.2k
6	Cigna fee schedule · outpatient · +34 other terms	545	$354	$371	$301	81%	63–126	$36 – $3.8k
7	Aetna fee schedule · outpatient · +37 other terms	722	$213	$381	$536	141%	54–315	$1 – $15.6k
8	Blue Cross Blue Shield fee schedule · outpatient · +35 other terms	528	$289	$333	$247	74%	45–144	$1 – $3.5k
9	Bcbs Mt fee schedule · outpatient · +2 other terms	1	$409	$409	—	—	34	$409 – $409
10	Florida Blue fee schedule · outpatient · +2 other terms	1	$261	$261	$63	24%	6–60	$200 – $380
11	Humana fee schedule · outpatient · +34 other terms	446	$187	$268	$277	103%	5–50	$1 – $1.7k
12	Medica fee schedule · outpatient · +26 other terms	53	$280	$328	$237	72%	4–40	$36 – $1.2k
13	Bcbs In other · both · +1 other terms	11	$640	$661	$104	16%	4–40	$426 – $850
14	Tricare facility · fee schedule · outpatient · +21 other terms	88	$176	$220	$340	154%	2–20	$72 – $4.6k
15	Optum fee schedule · outpatient · +26 other terms	58	$164	$396	$449	113%	2–20	$41 – $1.9k
16	Kaiser fee schedule · outpatient · +28 other terms	111	$256	$347	$294	85%	1–10	$39 – $1.8k
17	First Health fee schedule · outpatient · +20 other terms	68	$332	$426	$451	106%	1–10	$46 – $1.6k
18	Excellus facility · fee schedule · both · +17 other terms	28	$215	$220	$143	65%	1–10	$30 – $550
19	Premera facility · fee schedule · both · +17 other terms	28	$230	$277	$112	41%	1–10	$163 – $550
20	Wellmark facility · fee schedule · both · +24 other terms	27	$230	$264	$111	42%	1–10	$163 – $550
21	WellCare fee schedule · outpatient · +28 other terms	206	$187	$197	$143	73%	—	$30 – $1.2k
22	MultiPlan fee schedule · outpatient · +24 other terms	127	$612	$677	$525	78%	—	$50 – $2.6k
23	Ambetter fee schedule · outpatient · +25 other terms	121	$296	$263	$211	80%	—	$18 – $2.3k
24	Devoted facility · fee schedule · outpatient · +20 other terms	101	$176	$217	$360	166%	—	$152 – $4.9k
25	Caresource fee schedule · outpatient · +23 other terms	94	$181	$187	$69	37%	—	$1 – $462

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