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

XR UPPER GI, W/SMALL BOWEL

UnitedHealthcare pricing summary

Low

Average

$461

Median

$338

High

$34.4k

UnitedHealthcare rate distribution

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3,884 hospital rates

#		Plans
1	North Arkansas Regional Medical Center Harrison, AR fee schedule · outpatient	1	$123	$123	—	—	910	$123 – $123
2	North Arkansas Regional Medical Center Harrison, AR fee schedule · inpatient	1	$123	$123	—	—	709	$123 – $123
3	Childrens Hospital Colorado Aurora, CO percent of total billed charges · outpatientfrom % of charges	2	$402	$402	$15	4%	120	$388 – $417
4	North Carolina Baptist Hospital Winston Salem, NC percent of total billed charges · outpatientfrom % of charges	3	$281	$253	$44	17%	50	$190 – $287
5	North Carolina Baptist Hospital Bermuda Run, NC percent of total billed charges · outpatientfrom % of charges	3	$266	$240	$42	17%	50	$180 – $272
6	METHODIST LEBONHEUR GERMANTOWN HOSP GERMANTOWN, TN fee schedule · both	10	$292	$248	$82	33%	46–55	$44 – $292
7	Mercy Hospital Springfield Ozark, MO facility · other · outpatient	2	$172	$172	—	—	46	$172 – $172
8	Mercy Hospital Springfield Springfield, MO facility · other · outpatient	2	$172	$172	—	—	46	$172 – $172
9	BAPTIST HEALTHCARE SYSTEM INC Corbin, KY percent of total billed charges · outpatientfrom % of charges	2	$1.1k	$1.1k	$866	77%	36	$264 – $2.0k
10	RAPIDES REGIONAL MEDICAL CENTER ALEXANDRIA, LA percent of total billed charges · outpatientfrom % of charges	4	$355	$511	$442	87%	36	$127 – $1.2k
11	Seattle Children's Hospital Seattle, WA professional · fee schedule · both	4	$96	$69	$37	53%	33–51	$24 – $100
12	BAPTIST HEALTHCARE SYSTEM INC Lexington, KY percent of total billed charges · outpatientfrom % of charges	1	$297	$297	—	—	29	$297 – $297
13	CATHOLIC HEALTH INITIATIVES COLORADO Lakewood, CO other · inpatient	5	$174	$180	$40	22%	27–63	$136 – $255
14	Saint Francis Hospital and Medical Center Hartford, CT facility · other · both	1	$210	$210	—	—	27	$210 – $210
15	HARTFORD HOSPITAL HARTFORD, CT fee schedule · outpatient	1	$280	$280	—	—	24	$280 – $280
16	Monument Health Rapid City Hospital Inc City, SD percent of total billed charges · outpatientfrom % of charges	1	$848	$848	—	—	24	$848 – $848
17	Pitt County Memorial Hospital, Inc. Greenville, NC other · both	2	$170	$170	—	—	24	$170 – $170
18	Pitt County Memorial Hospital, Inc. Washington, NC other · both	2	$170	$170	—	—	24	$170 – $170
19	STATE OF MISSISSIPPI-UNIVERSITY OF MISSISSIPPI MEDICAL CENTER JACKSON, MS other · outpatient	2	$445	$445	$282	63%	23–32	$163 – $727
20	Arkansas Childrens Northwest Springdale, AR facility · percent of total billed charges · outpatientfrom % of charges	1	$266	$266	—	—	22	$266 – $266
21	HARTFORD HOSPITAL HARTFORD, CT other · outpatient	1	$72	$72	—	—	21	$72 – $72
22	LUCILE SALTER PACKARD CHILDREN'S HOSPITAL AT STANFORD PALO ALTO, CA per diem · outpatient	1	$28.5k	$28.5k	—	—	20	$28.5k – $28.5k
23	Fairview Health Services Minneapolis, MN other · inpatient	2	$236	$236	$48	20%	19–28	$188 – $284
24	METHODIST LEBONHEUR CHILDRENS HOSP TN 38301; 7691 POPLAR AVE. MEMPHIS, TN fee schedule · both	4	$326	$299	$117	39%	19–37	$136 – $410
25	Self Regional Healthcare Greenwood, SC facility · other · outpatient	1	$178	$178	—	—	19	$178 – $178

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CPT 74240