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
$1
Average
$387
Median
$316
High
$12.8k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
777 hospitals; the 90th percentile is 8.2× 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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1,102 hospital rates
iThe hospitals that file a Molina 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 | DIGNITY HEALTH San Bernardino, CA fee schedule · outpatient | 3 | $114 | $227 | $160 | 70% | 3–30 | $114 – $454 |
| 2 | BAPTIST HEALTHCARE SYSTEM INC Corbin, KY percent of total billed charges · outpatientfrom % of charges | 1 | $411 | $411 | $137 | 33% | 2–20 | $274 – $549 |
| 3 | BAPTIST HEALTHCARE SYSTEM INC Lexington, KY percent of total billed charges · outpatientfrom % of charges | 1 | $463 | $463 | $154 | 33% | 2–20 | $309 – $617 |
| 4 | BAPTIST HEALTHCARE SYSTEM INC Richmond, KY percent of total billed charges · outpatientfrom % of charges | 1 | $463 | $463 | $154 | 33% | 2–20 | $309 – $617 |
| 5 | BAPTIST HEALTHCARE SYSTEM INC Grange, KY percent of total billed charges · outpatientfrom % of charges | 1 | $463 | $463 | $154 | 33% | 2–20 | $309 – $617 |
| 6 | BAPTIST HEALTHCARE SYSTEM INC Paducah, KY percent of total billed charges · outpatientfrom % of charges | 1 | $411 | $411 | $137 | 33% | 2–20 | $274 – $549 |
| 7 | BAPTIST HEALTHCARE SYSTEM INC. Louisville, KY percent of total billed charges · outpatientfrom % of charges | 1 | $566 | $566 | $189 | 33% | 2–20 | $377 – $754 |
| 8 | Columbus Regional Healthcare System, Inc Whiteville, NC percent of total billed charges · outpatientfrom % of charges | 1 | $307 | $307 | — | — | 1–10 | $307 – $307 |
| 9 | HARTFORD HOSPITAL HARTFORD, CT other · outpatient | 1 | $143 | $143 | — | — | 1–10 | $143 – $143 |
| 10 | HOSPITAL OF CENTRAL CONNECTICUT AT NEW BRITAIN D/B/A THE HOSPITAL OF CENTRAL CONNECTICUT SOUTHINGTON, CT fee schedule · outpatient | 2 | $220 | $220 | $9 | 4% | 1–10 | $211 – $229 |
| 11 | Methodist Hospitals of Dallas Dallas, TX other · both | 2 | $438 | $438 | $70 | 16% | 1–10 | $368 – $508 |
| 12 | Public Hospital Dis No 1 Skagit dba Skagit Valley Hospital Vernon, WA fee schedule · both | 1 | $12.8k | $12.8k | — | — | 1–10 | $12.8k – $12.8k |
| 13 | Spencer Municipal Hospital Spencer, IA case rate · outpatient | 1 | $342 | $342 | — | — | 1–10 | $342 – $342 |
| 14 | Wesley Health System LLC Hattiesburg, MS facility · other · outpatient | 2 | $284 | $284 | $10 | 3% | 1–10 | $275 – $294 |
| 15 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $125 | $125 | — | — | — | $125 – $125 |
| 16 | AKRON GENERAL MEDICAL CENTER Akron, OH professional · fee schedule · outpatient | 1 | $80 | $80 | — | — | — | $80 – $80 |
| 17 | ALLE-KISKI MEDICAL CENTER NATRONA HEIGHTS, PA fee schedule · outpatient | 1 | $374 | $374 | — | — | — | $374 – $374 |
| 18 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 1 | $369 | $369 | — | — | — | $369 – $369 |
| 19 | AMH Cath Labs LLC Arlington, TX fee schedule · outpatient | 1 | $84 | $84 | — | — | — | $84 – $84 |
| 20 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH per diem · inpatient | 2 | $5.4k | $5.4k | — | — | — | $5.4k – $5.4k |
| 21 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · inpatientfrom % of charges | 2 | $897 | $897 | $1 | 0% | — | $896 – $898 |
| 22 | ARTHUR G JAMES CANCER HOSPITAL AND RESEARCH INSTITUTE Columbus, OH percent of total billed charges · outpatientfrom % of charges | 4 | $674 | $697 | $86 | 12% | — | $617 – $823 |
| 23 | Adena Fayette Medical Center Washington Court House, OH facility · case rate · outpatient | 1 | $731 | $731 | — | — | — | $731 – $731 |
| 24 | Adena Fayette Medical Center Washington Court House, OH facility · percent of total billed charges · outpatientfrom % of charges | 1 | $512 | $512 | — | — | — | $512 – $512 |
| 25 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 2 | $508 | $508 | $175 | 34% | — | $333 – $683 |
← Payers reporting CPT 74420 · Snapshot 20261111T120946Z-9134e7f7