| Code | Description | States | Median rate |
|---|---|---|---|
| 74018 | Abdominal X-ray, 1 view | 48 | $23.74 |
| 74019 | Abdominal X-ray, 2 views | 48 | $29.09 |
| 74021 | Abdominal X-ray, 3 or more views | 48 | $33.79 |
| 74022 | Acute abdomen X-ray series with chest view | 48 | $39.89 |
| 74150 | CT scan of the abdomen without contrast | 48 | $128.84 |
| 74160 | CT scan of the abdomen with contrast | 48 | $208.76 |
| 74170 | CT scan of the abdomen, without then with contrast | 48 | $237.64 |
| 74174 | CT angiogram of the abdomen and pelvis | 48 | $350.50 |
| 74175 | CT angiogram of the abdomen | 48 | $271.92 |
| 74176 | CT scan of the abdomen and pelvis without contrast | 48 | $158.56 |
| 74177 | CT scan of the abdomen and pelvis with contrast | 48 | $260.13 |
| 74178 | CT of the abdomen and pelvis, without then with contrast | 48 | $311.79 |
| 74181 | MRI of the abdomen without contrast | 48 | $192.64 |
| 74182 | MRI of the abdomen with contrast | 48 | $299.47 |
| 74183 | MRI of the abdomen, without then with contrast | 48 | $334.38 |
| 74185 | MR angiogram of the abdomen | 47 | $325.88 |
| 74210 | Barium X-ray of the throat and upper esophagus | 48 | $72.81 |
| 74220 | Barium X-ray of the esophagus | 48 | $75.53 |
| 74221 | Barium X-ray of the esophagus, double contrast | 47 | $89.39 |
| 74230 | Video X-ray swallowing study | 48 | $95.98 |
| 74240 | Upper GI X-ray series with contrast | 48 | $97.77 |
| 74248 | Small bowel follow-through X-ray (add-on) | 46 | $67.48 |
| 74250 | Small intestine X-ray series with barium | 48 | $94.67 |
| 74261 | CT colonography (virtual colonoscopy) without contrast | 38 | $321.59 |
| 74262 | CT colonography (virtual colonoscopy) with contrast | 39 | $350.80 |
| 74263 | CT colonography (virtual colonoscopy), screening | 22 | $492.19 |
| 74270 | Barium enema X-ray of the colon, single contrast | 48 | $118.74 |
| 74280 | Barium enema X-ray, with air contrast | 48 | $168.80 |
| 74283 | Enema to unfold a telescoped bowel (intussusception) | 47 | $200.78 |
| 74290 | Gallbladder X-ray with oral contrast | 48 | $64.41 |
| 74300 | Bile duct X-ray during surgery, reading | 47 | $42.60 |
| 74301 | Bile duct X-ray during surgery, added set (add-on) | 45 | $25.22 |
| 74328 | Bile duct X-ray during endoscopy, reading | 47 | $113.65 |
| 74329 | Pancreatic duct X-ray during endoscopy, reading | 47 | $116.12 |
| 74330 | Bile and pancreatic duct X-ray during endoscopy, reading | 47 | $118.51 |
| 74400 | Kidney X-ray with IV dye (intravenous pyelogram) | 48 | $104.22 |
| 74425 | Kidney X-ray with dye through a drainage tube, reading | 47 | $105.05 |
| 74430 | Bladder X-ray with dye, reading | 48 | $36.34 |
| 74450 | Urethra and bladder X-ray with dye from below, reading | 47 | $53.75 |
| 74455 | Voiding bladder and urethra X-ray, reading | 48 | $82.98 |
| 74712 | Fetal MRI, single or first fetus | 44 | $356.03 |
| 74713 | Fetal MRI, each added fetus | 43 | $170.72 |
| 74740 | Uterus and tube X-ray with dye (HSG), reading | 47 | $72.75 |
| 74742 | Fallopian tube catheterization X-ray, reading | 39 | $110.66 |
Published Medicaid fee-for-service schedule amounts, not a coverage or eligibility guarantee. Managed-care plan rates can differ. Where no prior-authorization flag is shown, the state does not publish one. Descriptions are ProviderSignal's own plain-language labels or public-domain CMS text.