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Lung Artery Dye X-Ray, One Side

New Hampshire rates for HCPCS 75741

X-ray imaging of the arteries supplying one lung, taken after a thin tube is guided into the artery and contrast dye is injected directly into it. Only the vessels on that one side are studied. It is used to look for a blood clot, a narrowing, or an abnormal connection between vessels in the lung.

Rates data updated October 2026.

How much does Lung Artery Dye X-Ray, One Side cost?

$224

Typical negotiated rate. In New Hampshire, October 2026.

Insurers have agreed to pay about $224 for this service. Most negotiated rates run $178 to $339.

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.

How much rates vary

Facilitymedian $724 · 10th to 90th $447 to $14,454Professionalmedian $209 · 10th to 90th $141 to $501
$100$200$500$1K$2K$5K$10Kfacility $724professional $209

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

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None (both parts)
Typical Low
$117.49
Median
$223.87
Typical High
$229.09
Aetna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$46.77
Median
$64.57
Typical High
$81.28
Aetna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$70.79
Median
$158.49
Typical High
$162.18
Anthem BCBS
Setting
Facility
Modifier
None
Typical Low
$562.34
Median
$794.33
Typical High
$794.33
Anthem BCBS
Setting
Professional
Modifier
None (both parts)
Typical Low
$128.82
Median
$186.21
Typical High
$363.08
Anthem BCBS
Setting
Professional
Modifier
26 · Professional part
Typical Low
$58.88
Median
$85.11
Typical High
$147.91
Anthem BCBS
Setting
Professional
Modifier
TC · Technical part
Typical Low
$69.18
Median
$100.00
Typical High
$177.83
Cigna
Setting
Facility
Modifier
None
Typical Low
$446.68
Median
$707.95
Typical High
$17,782.79
Cigna
Setting
Professional
Modifier
None (both parts)
Typical Low
$165.96
Median
$186.21
Typical High
$537.03
Cigna
Setting
Professional
Modifier
26 · Professional part
Typical Low
$70.79
Median
$85.11
Typical High
$173.78
Cigna
Setting
Professional
Modifier
TC · Technical part
Typical Low
$93.33
Median
$107.15
Typical High
$323.59
Harvard Pilgrim
Setting
Professional
Modifier
None (both parts)
Typical Low
$141.25
Median
$229.09
Typical High
$512.86
Harvard Pilgrim
Setting
Professional
Modifier
26 · Professional part
Typical Low
$64.57
Median
$100.00
Typical High
$181.97
Harvard Pilgrim
Setting
Professional
Modifier
TC · Technical part
Typical Low
$75.86
Median
$125.89
Typical High
$251.19
United
Setting
Professional
Modifier
None (both parts)
Typical Low
$177.83
Median
$234.42
Typical High
$575.44
United
Setting
Professional
Modifier
26 · Professional part
Typical Low
$69.18
Median
$85.11
Typical High
$165.96
United
Setting
Professional
Modifier
TC · Technical part
Typical Low
$100.00
Median
$128.82
Typical High
$371.54
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
$58.88
Median
$112.20
Typical High
$117.49
Aetna
Setting
Professional
Modifier
53 · Discontinued
Typical Low
$23.44
Median
$44.67
Typical High
$46.77
Aetna
Setting
Professional
Modifier
FX · Film X-ray
Typical Low
$95.50
Median
$177.83
Typical High
$177.83

Where New Hampshire sits

The same service costs 5.4 times more in Alaska than in Utah. 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.

New Hampshire· 18th of 51

$224

AK $407UT $75.86

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.