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Upper Digestive Tract X-Ray, Detailed Contrast Study

Wisconsin 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 $575 · 10th to 90th $513 to $871Professionalmedian $891 · 10th to 90th $355 to $891
$200$500$1Kfacility $575professional $891

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
Facility
Modifier
None
Typical Low
$512.86
Median
$575.44
Typical High
$870.96
Cigna
Setting
Professional
Modifier
None (both parts)
Typical Low
$288.40
Median
$676.08
Typical High
$758.58
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$64.57
Median
$154.88
Typical High
$177.83
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$223.87
Median
$524.81
Typical High
$588.84
Medica
Setting
Professional
Modifier
None (both parts)
Typical Low
$891.25
Median
$891.25
Typical High
$891.25
Medica
Setting
Professional
Modifier
26 · Professional part
Typical Low
$223.87
Median
$223.87
Typical High
$223.87
Medica
Setting
Professional
Modifier
TC · Technical part
Typical Low
$616.60
Median
$616.60
Typical High
$616.60