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Kidney Dye X-Ray With Drip and Tomograms

Louisiana rates for HCPCS 74415

X-ray study of the kidneys, ureters and bladder using contrast dye given into a vein as a drip or a rapid injection, with pictures taken as the kidneys clear the dye into the urine. It also includes tomograms, images focused on one layer of the kidney at a time, which show the kidney tissue more clearly than the plain views.

Rates data updated October 2026.

How much does Kidney Dye X-Ray With Drip and Tomograms cost?

$170

Typical negotiated rate. In Louisiana, October 2026.

Insurers have agreed to pay about $170 for this service. The price depends on where it is billed: about $162 from a physician practice, and about $282 from a hospital or other facility.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$162$110 to $182
FacilityA hospital or hospital-owned outpatient department$282$219 to $372

How much rates vary

Facilitymedian $282 · 10th to 90th $191 to $501Professionalmedian $162 · 10th to 90th $87 to $195
$100$200$500facility $282professional $162

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
None
Typical Low
$162.18
Median
$169.82
Typical High
$199.53
Aetna
Setting
Facility
Modifier
TC · Technical part
Typical Low
$134.90
Median
$186.21
Typical High
$549.54
Aetna
Setting
Professional
Modifier
None (both parts)
Typical Low
$162.18
Median
$162.18
Typical High
$177.83
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$26.92
Median
$28.84
Typical High
$31.62
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$134.90
Median
$134.90
Typical High
$147.91
BCBS Louisiana
Setting
Facility
Modifier
None
Typical Low
$190.55
Median
$288.40
Typical High
$478.63
BCBS Louisiana
Setting
Professional
Modifier
None (both parts)
Typical Low
$169.82
Median
$181.97
Typical High
$186.21
BCBS Louisiana
Setting
Professional
Modifier
26 · Professional part
Typical Low
$26.92
Median
$29.51
Typical High
$34.67
BCBS Louisiana
Setting
Professional
Modifier
TC · Technical part
Typical Low
$138.04
Median
$151.36
Typical High
$151.36
Christus
Setting
Facility
Modifier
None
Typical Low
$39.81
Median
$39.81
Typical High
$144.54
Christus
Setting
Professional
Modifier
26 · Professional part
Typical Low
$21.88
Median
$22.39
Typical High
$22.39
Cigna
Setting
Facility
Modifier
None
Typical Low
$263.03
Median
$363.08
Typical High
$562.34
Cigna
Setting
Professional
Modifier
None (both parts)
Typical Low
$85.11
Median
$95.50
Typical High
$213.80
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$14.13
Median
$15.14
Typical High
$38.90
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$70.79
Median
$79.43
Typical High
$177.83
United
Setting
Facility
Modifier
None
Typical Low
$199.53
Median
$263.03
Typical High
$489.78
United
Setting
Professional
Modifier
None (both parts)
Typical Low
$91.20
Median
$138.04
Typical High
$199.53
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$19.50
Median
$23.44
Typical High
$37.15
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$69.18
Median
$117.49
Typical High
$169.82
6 more rates with less common billing modifiers

A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.

Insurance Carrier
Aetna
Setting
Facility
Modifier
52 · Reduced service
Typical Low
$67.61
Median
$93.33
Typical High
$275.42
Aetna
Setting
Facility
Modifier
53 · Discontinued
Typical Low
$26.92
Median
$37.15
Typical High
$109.65
Aetna
Setting
Facility
Modifier
FX · Film X-ray
Typical Low
$107.15
Median
$151.36
Typical High
$436.52
Aetna
Setting
Professional
Modifier
52 · Reduced service
Typical Low
$81.28
Median
$81.28
Typical High
$89.13
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$32.36
Median
$32.36
Typical High
$35.48
Aetna
Setting
Professional
Modifier
FX · Film X-ray
Typical Low
$128.82
Median
$131.83
Typical High
$141.25

Where Louisiana sits

The same service costs 3.8 times more in Alaska than in Florida. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Louisiana· 25th of 51

$170

AK $447FL $117

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.