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Kidney Dye X-Ray With Drip and Tomograms

Utah 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?

$126

Typical negotiated rate. In Utah, October 2026.

Insurers have agreed to pay about $126 for this service. The price depends on where it is billed: about $126 from a physician practice, and about $347 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 7 insurance carriers under federal price transparency rules.

Prices by location type

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$126$105 to $155
FacilityA hospital or hospital-owned outpatient department$347$195 to $468

How much rates vary

Facilitymedian $347 · 10th to 90th $148 to $759Professionalmedian $126 · 10th to 90th $93 to $251
$50$100$200$500$1Kfacility $347professional $126

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
$147.91
Median
$147.91
Typical High
$147.91
Aetna
Setting
Professional
Modifier
None (both parts)
Typical Low
$138.04
Median
$147.91
Typical High
$223.87
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$22.39
Median
$26.92
Typical High
$34.67
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$117.49
Median
$120.23
Typical High
$190.55
Cigna
Setting
Facility
Modifier
None
Typical Low
$194.98
Median
$323.59
Typical High
$1,513.56
Cigna
Setting
Professional
Modifier
None (both parts)
Typical Low
$128.82
Median
$128.82
Typical High
$251.19
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$26.92
Median
$26.92
Typical High
$38.02
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$102.33
Median
$102.33
Typical High
$208.93
Molina
Setting
Professional
Modifier
None (both parts)
Typical Low
$91.20
Median
$109.65
Typical High
$138.04
Regence BlueShield
Setting
Facility
Modifier
None
Typical Low
$295.12
Median
$380.19
Typical High
$776.25
Regence BlueShield
Setting
Professional
Modifier
None (both parts)
Typical Low
$213.80
Median
$251.19
Typical High
$295.12
Regence BlueShield
Setting
Professional
Modifier
26 · Professional part
Typical Low
$32.36
Median
$37.15
Typical High
$46.77
Regence BlueShield
Setting
Professional
Modifier
TC · Technical part
Typical Low
$177.83
Median
$208.93
Typical High
$245.47
Select Health
Setting
Facility
Modifier
None
Typical Low
$234.42
Median
$234.42
Typical High
$234.42
Select Health
Setting
Professional
Modifier
None (both parts)
Typical Low
$141.25
Median
$173.78
Typical High
$354.81
U of Utah Health Plan
Setting
Professional
Modifier
None
Typical Low
$30.90
Median
$144.54
Typical High
$295.12
United
Setting
Professional
Modifier
None (both parts)
Typical Low
$125.89
Median
$154.88
Typical High
$269.15
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$23.44
Median
$25.12
Typical High
$40.74
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$104.71
Median
$128.82
Typical High
$213.80
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
$74.13
Median
$74.13
Typical High
$112.20
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$29.51
Median
$29.51
Typical High
$44.67
Aetna
Setting
Professional
Modifier
FX · Film X-ray
Typical Low
$117.49
Median
$117.49
Typical High
$141.25

Where Utah 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.

Utah· 49th of 51

$126

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.