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Upper Digestive Tract X-Ray, Detailed Contrast Study

South Dakota 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.

Professionalmedian $447 · 10th–90th $251$5620%20%10th90th$447$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Cigna
Setting
Professional
Modifier
Global
Typical Low
$354.81
Median
$446.68
Typical High
$562.34
Medica
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$891.25
Typical High
$891.25
Sanford Health Plan
Setting
Professional
Modifier
Global
Typical Low
$169.82
Median
$251.19
Typical High
$309.03