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.
Original text from hospital filings
HC DI PYELOGRAM RETROGRADE
Low
$0
Average
$871
Median
$595
High
$202.1k
Each hospital's average Cigna rate, under the methodology and billing class chosen below.
1629 hospitals; the 90th percentile is 6.7× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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2,465 hospital rates
iThe hospitals that file a Cigna rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Mayo Clinic Arizona Phoenix, AZ facility · percent of total billed charges · bothfrom % of charges | 3 | $538 | $538 | $22 | 4% | 27 | $515 – $560 |
| 2 | DIGNITY HEALTH Gilbert, AZ fee schedule · outpatient | 5 | $860 | $861 | $276 | 32% | 24 | $381 – $1.1k |
| 3 | Medical Park Hospital LLC Winston-Salem, NC percent of total billed charges · outpatientfrom % of charges | 1 | $476 | $476 | — | — | 21 | $476 – $476 |
| 4 | DIGNITY COMMUNITY CARE Chandler, AZ fee schedule · outpatient | 4 | $832 | $717 | $392 | 55% | 20–38 | $74 – $1.1k |
| 5 | Mayo Clinic Florida Jacksonville, FL facility · percent of total billed charges · bothfrom % of charges | 3 | $841 | $841 | $93 | 11% | 16 | $748 – $935 |
| 6 | Saint Luke’s East Hospital Summit, MO fee schedule · both | 7 | $163 | $261 | $121 | 46% | 15 | $163 – $460 |
| 7 | Novant Health Matthews Medical Center LLC Matthews, NC percent of total billed charges · outpatientfrom % of charges | 1 | $448 | $448 | — | — | 13 | $448 – $448 |
| 8 | Public Hospital Dis No 1 Skagit dba Skagit Valley Hospital Vernon, WA percent of total billed charges · bothfrom % of charges | 1 | $1.3k | $1.3k | — | — | 13 | $1.3k – $1.3k |
| 9 | University of Wisconsin Hospital and Clinics Authority WI 53718; 1675 Highland Ave Madison, WI percent of total billed chargesfrom % of charges | 1 | $1.1k | $1.1k | $380 | 33% | 13 | $760 – $1.5k |
| 10 | Atrium Health Hospitals Inc Kings Mountain, NC percent of total billed charges · outpatientfrom % of charges | 4 | $791 | $804 | $188 | 23% | 4–40 | $574 – $1.1k |
| 11 | Alton Memorial Hospital Alton, IL fee schedule · both | 3 | $184 | $179 | $9 | 5% | 3–30 | $167 – $186 |
| 12 | Camden-Clark Memorial Hospital Corporation Parkersburg, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.3k | $1.3k | $32 | 3% | 3–30 | $1.2k – $1.3k |
| 13 | RAPIDES REGIONAL MEDICAL CENTER ALEXANDRIA, LA percent of total billed charges · outpatientfrom % of charges | 1 | $421 | $421 | — | — | 3–30 | $421 – $421 |
| 14 | Carolinas Medical Center Charlotte, NC percent of total billed charges · outpatientfrom % of charges | 4 | $791 | $804 | $188 | 23% | 2–20 | $574 – $1.1k |
| 15 | City Hospital, Inc. Martinsburg, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.1k | $1.1k | — | — | 2–20 | $1.1k – $1.1k |
| 16 | FRANCISCAN ALLIANCE, INC. dba FRANCISCAN HEALTH CROWN POINT CROWN POINT, IN percent of total billed charges · bothfrom % of charges | 5 | $847 | $704 | $159 | 23% | 2–20 | $525 – $847 |
| 17 | Herbert J Thomas Memorial Hospital Association South Charleston, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $2.4k | $2.4k | — | — | 2–20 | $2.4k – $2.4k |
| 18 | Mayo Clinic Rochester, MN facility · percent of total billed charges · bothfrom % of charges | 4 | $836 | $845 | $18 | 2% | 2–20 | $836 – $880 |
| 19 | SOUTH COUNTY HEALTH Greenwich, RI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $784 | $784 | — | — | 2–20 | $784 – $784 |
| 20 | UCHMHS Colorado Springs, CO percent of total billed charges · outpatientfrom % of charges | 4 | $657 | $676 | $89 | 13% | 2–20 | $572 – $817 |
| 21 | UCHMHS Colorado Springs, CO percent of total billed charges · outpatientfrom % of charges | 4 | $657 | $676 | $89 | 13% | 2–20 | $572 – $817 |
| 22 | University of Virginia Medical Center Charlottesville, VA fee schedule · both | 3 | $265 | $268 | $25 | 9% | 2–20 | $238 – $299 |
| 23 | University of Virginia Medical Center Charlottesville, VA fee schedule · outpatient | 3 | $14.4k | $14.6k | $1.4k | 9% | 2–20 | $13.0k – $16.3k |
| 24 | West Virginia University Hospitals, Inc. Morgantown, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $1.6k | $1.6k | — | — | 2–20 | $1.6k – $1.6k |
| 25 | Wheeling Hospital, Inc. Wheeling, WV facility · percent of total billed charges · outpatientfrom % of charges | 1 | $926 | $926 | — | — | 2–20 | $926 – $926 |
← Payers reporting CPT 74420 · Snapshot 20261111T120946Z-9134e7f7