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
PERITONEOGRAM RS&I
Arlington, TX
See all hospitals reporting CPT 74190 →Price type
AMH Cath Labs LLC’s median price of $555 is 3% below the median hospital's median price ($575), higher than 45% of the 1,793 hospitals reporting CPT 74190. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 6 payers, 13 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.
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| # | |||||||
|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield managed medicaid fee schedule · outpatient | $81 | $81 | — | — | — | $81 – $81 |
| 2 | UnitedHealthcare managed medicaid fee schedule · outpatient | $81 | $81 | — | — | — | $81 – $81 |
| 3 | WellCare managed medicaid fee schedule · outpatient | $85 | $85 | — | — | — | $85 – $85 |
| 4 | Molina managed medicaid fee schedule · outpatient | $88 | $88 | — | — | — | $88 – $88 |
| 5 | Aetna managed medicaid fee schedule · outpatient | $89 | $89 | — | — | — | $89 – $89 |
| 6 | Blue Cross Blue Shield medicare advantage case rate · outpatient | $550 | $550 | — | — | — | $550 – $550 |
| 7 | Humana medicare advantage case rate · outpatient | $572 | $572 | — | — | — | $572 – $572 |
| 8 | Humana medicare advantage ppo case rate · outpatient | $572 | $572 | — | — | — | $572 – $572 |
| 9 | Molina medicare advantage case rate · outpatient | $577 | $577 | — | — | — | $577 – $577 |
| 10 | WellCare medicare advantage hmo case rate · outpatient | $577 | $577 | — | — | — | $577 – $577 |
| 11 | WellCare medicare advantage mmp case rate · outpatient | $605 | $605 | — | — | — | $605 – $605 |
| 12 | UnitedHealthcare medicare advantage ppo case rate · outpatient | $610 | $610 | — | — | — | $610 – $610 |
| 13 | UnitedHealthcare medicare advantage hmo case rate · outpatient | $621 | $621 | — | — | — | $621 – $621 |
Last updated: Apr 21, 2026
See Abdominal cavity X-ray with contrast, read by radiologist pricing across every hospital in the network reporting it, or ask Claude or any MCP client directly — see how to connect.