X-ray of the urinary tract 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

HC DI PYELOGRAM RETROGRADE

Payers reporting CPT 74420

Payer pricing summary

Low

$41

Average

$532

Median

$470

High

$1.5k

Payer rate distribution

Filter by billing methodology

Filter by billing class

#
1	Blue Cross Blue Shield fee schedule · outpatient · +36 other terms	512	$347	$352	$421	120%	74–101	$1 – $4.2k
2	Bcbs Mt fee schedule · outpatient · +2 other terms	1	$820	$820	—	—	55	$820 – $820
3	Cigna fee schedule · outpatient · +32 other terms	525	$413	$618	$888	144%	49–112	$17 – $16.3k
4	UnitedHealthcare fee schedule · outpatient · +38 other terms	788	$532	$525	$435	83%	33–114	$1 – $10.5k
5	Anthem fee schedule · outpatient · +30 other terms	200	$225	$246	$320	130%	18–72	$8 – $3.4k
6	Medicare other · both · +21 other terms	44	$371	$383	$69	18%	16–52	$132 – $513
7	Aetna fee schedule · outpatient · +37 other terms	708	$358	$447	$556	124%	6–60	$1 – $9.5k
8	Humana fee schedule · outpatient · +33 other terms	434	$353	$394	$480	122%	5–50	$1 – $3.3k
9	Molina fee schedule · outpatient · +34 other terms	265	$285	$236	$198	84%	4–40	$1 – $945
10	First Health fee schedule · outpatient · +20 other terms	68	$538	$695	$962	138%	2–20	$30 – $4.4k
11	Bcbs In other · both · +1 other terms	11	$1.3k	$1.3k	$206	16%	2–20	$847 – $1.7k
12	WellCare fee schedule · outpatient · +25 other terms	196	$358	$332	$170	51%	1–10	$23 – $837
13	Ucare professional · fee schedule · outpatient · +19 other terms	25	$21	$38	$26	69%	1–10	$11 – $95
14	MultiPlan fee schedule · outpatient · +24 other terms	132	$845	$940	$913	97%	—	$28 – $4.4k
15	Kaiser fee schedule · outpatient · +26 other terms	110	$421	$570	$545	96%	—	$1 – $3.3k
16	Ambetter fee schedule · outpatient · +23 other terms	107	$533	$416	$306	74%	—	$6 – $1.5k
17	Devoted facility · fee schedule · outpatient · +19 other terms	98	$352	$385	$385	100%	—	$9 – $4.9k
18	Aetna Better Health fee schedule · outpatient · +19 other terms	88	$84	$129	$127	98%	—	$31 – $1.3k
19	Caresource fee schedule · outpatient · +21 other terms	86	$293	$330	$360	109%	—	$1 – $3.4k
20	Tricare facility · fee schedule · outpatient · +22 other terms	80	$350	$368	$399	108%	—	$9 – $4.6k
21	Oscar facility · fee schedule · outpatient · +22 other terms	70	$510	$469	$199	42%	—	$88 – $1.2k
22	Highmark facility · fee schedule · outpatient · +22 other terms	67	$398	$395	$340	86%	—	$18 – $1.6k
23	Optum fee schedule · outpatient · +23 other terms	60	$332	$675	$958	142%	—	$23 – $4.2k
24	Amerihealth Caritas facility · fee schedule · outpatient · +17 other terms	52	$54	$167	$170	102%	—	$23 – $783
25	Medicaid facility · fee schedule · outpatient · +17 other terms	47	$245	$250	$139	56%	—	$23 – $462

Page 1 of 3 · 72 payers