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Upper Digestive Tract X-Ray, Detailed Contrast Study

Indiana rates for HCPCS 74249

This covers a detailed X-ray study of the upper digestive tract using a contrast liquid the patient swallows, with images taken as the contrast moves through the esophagus, stomach, and into the small intestine. This version uses a more detailed contrast technique intended to show the lining of the digestive tract in finer detail than a standard study. It is used to evaluate symptoms such as pain, difficulty swallowing, or a suspected abnormality in this part of the digestive tract.

Rates data updated October 2026.

How much rates vary

Facilitymedian $955 · 10th to 90th $575 to $2,188Professionalmedian $234 · 10th to 90th $166 to $363
$100$200$500$1K$2Kfacility $955professional $234

Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Cigna
Setting
Professional
Modifier
None (both parts)
Typical Low
$173.78
Median
$218.78
Typical High
$363.08
Physicians Health Plan of Northern Indiana
Setting
Facility
Modifier
None
Typical Low
$575.44
Median
$954.99
Typical High
$2,187.76
Physicians Health Plan of Northern Indiana
Setting
Professional
Modifier
None (both parts)
Typical Low
$125.89
Median
$234.42
Typical High
$331.13
Physicians Health Plan of Northern Indiana
Setting
Professional
Modifier
TC · Technical part
Typical Low
$123.03
Median
$177.83
Typical High
$245.47