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Kidney Dye X-Ray With Drip and Tomograms

Missouri 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?

$158

Typical negotiated rate. In Missouri, October 2026.

Insurers have agreed to pay about $158 for this service. The price depends on where it is billed: about $158 from a physician practice, and about $389 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 6 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$158$141 to $245
FacilityA hospital or hospital-owned outpatient department$389$186 to $562

How much rates vary

Facilitymedian $389 · 10th to 90th $151 to $912Professionalmedian $158 · 10th to 90th $129 to $1,023
$100$200$500$1Kfacility $389professional $158

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
$134.90
Median
$134.90
Typical High
$204.17
Aetna
Setting
Professional
Modifier
None (both parts)
Typical Low
$128.82
Median
$138.04
Typical High
$162.18
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$19.95
Median
$21.88
Typical High
$24.55
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$109.65
Median
$117.49
Typical High
$138.04
Anthem BCBS
Setting
Professional
Modifier
None (both parts)
Typical Low
$128.82
Median
$158.49
Typical High
$263.03
Anthem BCBS
Setting
Professional
Modifier
26 · Professional part
Typical Low
$24.55
Median
$36.31
Typical High
$47.86
Anthem BCBS
Setting
Professional
Modifier
TC · Technical part
Typical Low
$104.71
Median
$117.49
Typical High
$218.78
BCBS Kansas City
Setting
Facility
Modifier
None
Typical Low
$91.20
Median
$128.82
Typical High
$229.09
BCBS Kansas City
Setting
Professional
Modifier
None (both parts)
Typical Low
$151.36
Median
$165.96
Typical High
$199.53
BCBS Kansas City
Setting
Professional
Modifier
26 · Professional part
Typical Low
$24.55
Median
$25.70
Typical High
$33.11
BCBS Kansas City
Setting
Professional
Modifier
TC · Technical part
Typical Low
$128.82
Median
$138.04
Typical High
$169.82
Cigna
Setting
Facility
Modifier
None
Typical Low
$281.84
Median
$446.68
Typical High
$933.25
Cigna
Setting
Professional
Modifier
None (both parts)
Typical Low
$107.15
Median
$144.54
Typical High
$275.42
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$16.60
Median
$24.55
Typical High
$44.67
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$91.20
Median
$123.03
Typical High
$234.42
Medica
Setting
Facility
Modifier
None
Typical Low
$151.36
Median
$316.23
Typical High
$676.08
Medica
Setting
Professional
Modifier
None (both parts)
Typical Low
$141.25
Median
$1,023.29
Typical High
$1,023.29
Medica
Setting
Professional
Modifier
26 · Professional part
Typical Low
$24.55
Median
$223.87
Typical High
$223.87
Medica
Setting
Professional
Modifier
TC · Technical part
Typical Low
$117.49
Median
$870.96
Typical High
$870.96
United
Setting
Facility
Modifier
None
Typical Low
$549.54
Median
$549.54
Typical High
$588.84
United
Setting
Professional
Modifier
None (both parts)
Typical Low
$134.90
Median
$165.96
Typical High
$288.40
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$23.44
Median
$28.18
Typical High
$44.67
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$109.65
Median
$138.04
Typical High
$245.47
3 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
Professional
Modifier
52 · Reduced service
Typical Low
$64.57
Median
$69.18
Typical High
$81.28
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$25.70
Median
$27.54
Typical High
$33.11
Aetna
Setting
Professional
Modifier
FX · Film X-ray
Typical Low
$107.15
Median
$109.65
Typical High
$128.82

Where Missouri 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.

Missouri· 33rd of 51

$158

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.