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Kidney Dye X-Ray With Drip and Tomograms

New Hampshire 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 July 2026.

How much rates vary

Facilitymedian $89 · 10th to 90th $19 to $89
$20.0$50.0$100.0facility $89

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Small sample; interpret with caution. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
26 · Professional part
Typical Low
$89.13
Median
$89.13
Typical High
$89.13
Well Sense
Setting
Facility
Modifier
26 · Professional part
Typical Low
$17.38
Median
$19.05
Typical High
$22.91