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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 July 2026.

Facilitymedian $631 · 10th–90th $447$8710%20%10th90th$631Professionalmedian $676 · 10th–90th $288$9120%10%20%10th90th$676$100.0$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. Small sample; interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Cigna
Setting
Facility
Modifier
Global
Typical Low
$512.86
Median
$588.84
Typical High
$954.99
Cigna
Setting
Professional
Modifier
Global
Typical Low
$295.12
Median
$676.08
Typical High
$758.58
Medica
Setting
Facility
Modifier
Global
Typical Low
$630.96
Median
$630.96
Typical High
$630.96
Medica
Setting
Professional
Modifier
Global
Typical Low
$891.25
Median
$891.25
Typical High
$891.25
Molina
Setting
Professional
Modifier
Global
Typical Low
$50.12
Median
$54.95
Typical High
$70.79
Quartz
Setting
Facility
Modifier
Global
Typical Low
$446.68
Median
$630.96
Typical High
$630.96
Quartz
Setting
Professional
Modifier
Global
Typical Low
$467.74
Median
$912.01
Typical High
$912.01