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
DX HYSTEROSALPINGOGRAPHY S I
Haven, FL
See all hospitals reporting CPT 74740 →Price type
Winter Haven Hospital’s median price of $624 is 103% above the median hospital's median price ($307), higher than 83% of the 2,360 hospitals reporting CPT 74740. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.
Negotiated rates from the hospital’s own file: 10 payers, 47 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 | UnitedHealthcare medicaid hmo facility · case rate · outpatient | $77 | $77 | — | — | — | $77 – $77 |
| 2 | Humana medicaid hmo facility · case rate · outpatient | $78 | $78 | — | — | — | $78 – $78 |
| 3 | Molina medicaid hmo facility · case rate · outpatient | $79 | $79 | — | — | — | $79 – $79 |
| 4 | Aetna medicaid hmo facility · case rate · outpatient | $80 | $80 | — | — | — | $80 – $80 |
| 5 | Aetna commercial other facility · fee schedule · outpatient | $91 | $91 | — | — | — | $91 – $91 |
| 6 | Cigna commercial hmo facility · fee schedule · outpatient | $134 | $134 | — | — | — | $134 – $134 |
| 7 | Cigna commercial ppo facility · fee schedule · outpatient | $137 | $137 | — | — | — | $137 – $137 |
| 8 | Aetna commercial hmo facility · fee schedule · outpatient | $181 | $181 | — | — | — | $181 – $181 |
| 9 | Aetna medicare ppo facility · case rate · outpatient | $243 | $243 | — | — | — | $243 – $243 |
| 10 | Blue Cross Blue Shield medicare hmo facility · case rate · outpatient | $243 | $243 | — | — | — | $243 – $243 |
| 11 | Humana commercial other facility · case rate · outpatient | $252 | $252 | — | — | — | $252 – $252 |
| 12 | UnitedHealthcare medicare hmo facility · case rate · outpatient | $260 | $260 | — | — | — | $260 – $260 |
| 13 | Molina medicare hmo facility · percent of total billed charges · outpatientfrom % of charges | $260 | $260 | — | — | — | $260 – $260 |
| 14 | Aetna medicare hmo facility · case rate · outpatient | $279 | $279 | — | — | — | $279 – $279 |
| 15 | Cigna medicare hmo facility · case rate · outpatient | $279 | $279 | — | — | — | $279 – $279 |
| 16 | Humana medicare hmo facility · case rate · outpatient | $303 | $303 | — | — | — | $303 – $303 |
| 17 | WellCare medicare hmo facility · case rate · outpatient | $340 | $340 | — | — | — | $340 – $340 |
| 18 | Blue Cross Blue Shield commercial hmo my blue facility · percent of total billed charges · outpatientfrom % of charges | $461 | $461 | — | — | — | $461 – $461 |
| 19 | Ambetter commercial select core facility · case rate · outpatient | $546 | $546 | — | — | — | $546 – $546 |
| 20 | Blue Cross Blue Shield commercial hmo simply blue facility · percent of total billed charges · outpatientfrom % of charges | $604 | $604 | — | — | — | $604 – $604 |
| 21 | Ambetter commercial value facility · case rate · outpatient | $619 | $619 | — | — | — | $619 – $619 |
| 22 | Blue Cross Blue Shield commercial ppo blue select facility · percent of total billed charges · outpatientfrom % of charges | $624 | $624 | — | — | — | $624 – $624 |
| 23 | Aetna commercial other facility · percent of total billed charges · outpatientfrom % of charges | $668 | $668 | — | — | — | $668 – $668 |
| 24 | Aetna commercial hmo facility · percent of total billed charges · outpatientfrom % of charges | $698 | $698 | — | — | — | $698 – $698 |
| 25 | Blue Cross Blue Shield commercial hmo health options facility · percent of total billed charges · outpatientfrom % of charges | $736 | $736 | — | — | — | $736 – $736 |
Last updated: Jan 1, 2026
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