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Procedure price report · Upper gastrointestinal X-ray

Barium swallow X-ray of the esophagus, double contrast

CPT 74221the billing code this page is about

X-ray study of the swallowing tube using two contrast agents, such as barium plus a gas-producing agent, including any scout and delayed images taken.

Hospitals typically charge $476 cash for this outpatient procedure — the median across 1,840 hospitals that filed a usable cash price; the average of the middle 60% is $489. Most fall between $243 and $798 (20th–80th percentile).

Hospitals
1,840
States
50
Filings dated
Dec 2022 – Sep 2026
Computed
September 25, 2026
Prices checked
through September 24, 2026

Median: half of hospitals filed less, half more — and it is a price some hospital actually filed. Average of the middle 60%: the mean of the prices between the 20th and 80th percentiles. We never publish the plain average, the lowest or the highest price: the extremes in hospital price files are chargemaster artefacts, not prices anyone pays.

What hospitals charge, from cheapest to most expensive

Cash price percentiles, outpatient, across 1,840 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$172$277$476$734$1,109

The most expensive tenth of hospitals charges at least 6.5× what the cheapest tenth charges ($172 vs $1,109).

How the prices are spread

$122 – $157: 40 hospitals$122$157 – $203: 124 hospitals$203 – $261: 161 hospitals$203$261 – $337: 189 hospitals$337 – $434: 229 hospitals$337$434 – $559: 238 hospitals$559 – $721: 303 hospitals$559$721 – $929: 197 hospitals$929 – $1,197: 132 hospitals$929$1,197 – $1,542: 45 hospitals$1,197median $476price bands are equal on a log scale
Hospitals per price band (1,658 of 1,840 — the bands cover the 5th to 95th percentile)
FromToHospitals
$122$15740
$157$203124
$203$261161
$261$337189
$337$434229
$434$559238
$559$721303
$721$929197
$929$1,197132
$1,197$1,54245

Against Medicare

Medicare pays (OPPS 2026, national rate)$179
Median cash price$476
Cash as a multiple of Medicare2.7×

The Medicare figure is the national unadjusted OPPS rate for this code — what Medicare itself pays a hospital before local wage adjustment. It is a benchmark, not a price anyone is charged.

By state

The median cash price in each state, against the national median of $476.

Alaska: 9 hospitals filed a usable price — fewer than 10, so no figureAKMaine: median $365 across 20 hospitalsME$365Vermont: 8 hospitals filed a usable price — fewer than 10, so no figureVTNew Hampshire: median $503 across 16 hospitalsNH$503Washington: median $575 across 35 hospitalsWA$575Idaho: 9 hospitals filed a usable price — fewer than 10, so no figureIDMontana: 6 hospitals filed a usable price — fewer than 10, so no figureMTNorth Dakota: 7 hospitals filed a usable price — fewer than 10, so no figureNDMinnesota: median $261 across 41 hospitalsMN$261Illinois: median $720 across 67 hospitalsIL$720Wisconsin: median $472 across 83 hospitalsWI$472Michigan: median $460 across 56 hospitalsMI$460New York: median $337 across 62 hospitalsNY$337Massachusetts: median $643 across 39 hospitalsMA$643Oregon: median $671 across 26 hospitalsOR$671Nevada: median $600 across 11 hospitalsNV$600Wyoming: 5 hospitals filed a usable price — fewer than 10, so no figureWYSouth Dakota: 8 hospitals filed a usable price — fewer than 10, so no figureSDIowa: median $374 across 35 hospitalsIA$374Indiana: median $446 across 71 hospitalsIN$446Ohio: median $497 across 100 hospitalsOH$497Pennsylvania: median $351 across 91 hospitalsPA$351New Jersey: median $212 across 44 hospitalsNJ$212Connecticut: median $578 across 20 hospitalsCT$578Rhode Island: 6 hospitals filed a usable price — fewer than 10, so no figureRICalifornia: median $615 across 150 hospitalsCA$615Utah: median $580 across 27 hospitalsUT$580Colorado: median $589 across 36 hospitalsCO$589Nebraska: median $367 across 32 hospitalsNE$367Missouri: median $425 across 43 hospitalsMO$425Kentucky: median $347 across 26 hospitalsKY$347West Virginia: median $354 across 26 hospitalsWV$354Virginia: median $376 across 51 hospitalsVA$376Maryland: median $672 across 23 hospitalsMD$672Delaware: 5 hospitals filed a usable price — fewer than 10, so no figureDEArizona: median $254 across 21 hospitalsAZ$254New Mexico: 5 hospitals filed a usable price — fewer than 10, so no figureNMKansas: median $360 across 21 hospitalsKS$360Arkansas: median $107 across 10 hospitalsAR$107Tennessee: median $173 across 53 hospitalsTN$173North Carolina: median $352 across 56 hospitalsNC$352South Carolina: median $700 across 42 hospitalsSC$700Oklahoma: median $55 across 15 hospitalsOK$55Louisiana: median $221 across 29 hospitalsLA$221Mississippi: 9 hospitals filed a usable price — fewer than 10, so no figureMSAlabama: median $338 across 19 hospitalsAL$338Georgia: median $611 across 53 hospitalsGA$611Hawaii: median $337 across 10 hospitalsHI$337Texas: median $580 across 109 hospitalsTX$580Florida: median $825 across 94 hospitalsFL$825
Cash price by state, most expensive first. National median $476. A state needs at least 10 hospitals with a usable price to show a figure.
StateHospitalsMedianvs national20th–80th
Florida FL94$825+73%$355 – $2,247
Illinois IL67$720+51%$405 – $988
South Carolina SC42$700+47%$453 – $2,572
Maryland MD23$672+41%$443 – $844
Oregon OR26$671+41%$559 – $747
Massachusetts MA39$643+35%$401 – $765
California CA150$615+29%$277 – $1,109
Georgia GA53$611+28%$195 – $765
Nevada NV11$600+26%$336 – $946
Colorado CO36$589+24%$414 – $746
Utah UT27$580+22%$366 – $580
Texas TX109$580+22%$443 – $1,286
Connecticut CT20$578+21%$344 – $905
Washington WA35$575+21%$347 – $842
New Hampshire NH16$503+6%$421 – $1,173
Ohio OH100$497+5%$367 – $759
Wisconsin WI83$472−1%$247 – $667
Michigan MI56$460−3%$241 – $659
Indiana IN71$446−6%$316 – $526
Missouri MO43$425−11%$286 – $653
Virginia VA51$376−21%$256 – $588
Iowa IA35$374−21%$244 – $415
Nebraska NE32$367−23%$172 – $783
Maine ME20$365−23%$173 – $649
Kansas KS21$360−24%$304 – $630
West Virginia WV26$354−26%$289 – $506
North Carolina NC56$352−26%$261 – $503
Pennsylvania PA91$351−26%$207 – $775
Kentucky KY26$347−27%$231 – $1,609
Alabama AL19$338−29%$241 – $1,251
Hawaii HI10$337−29%$250 – $531
New York NY62$337−29%$211 – $621
Minnesota MN41$261−45%$171 – $339
Arizona AZ21$254−47%$164 – $613
Louisiana LA29$221−54%$126 – $345
New Jersey NJ44$212−56%$195 – $252
Tennessee TN53$173−64%$95 – $625
Arkansas AR10$107−78%$107 – $184
Oklahoma OK15$55−89%$55 – $395
Alaska AK9not enough hospitals filed a usable price
Idaho ID9not enough hospitals filed a usable price
Mississippi MS9not enough hospitals filed a usable price
South Dakota SD8not enough hospitals filed a usable price
Vermont VT8not enough hospitals filed a usable price
North Dakota ND7not enough hospitals filed a usable price
Montana MT6not enough hospitals filed a usable price
Rhode Island RI6not enough hospitals filed a usable price
Delaware DE5not enough hospitals filed a usable price
New Mexico NM5not enough hospitals filed a usable price
Wyoming WY5not enough hospitals filed a usable price

Hospitals like yours

The same distribution cut by the kind of hospital. Hospital type and ownership come from CMS; a hospital counts as part of a system when its price file is shared with at least one other hospital under the same brand. The national median is $476.

Cash price by hospital segment. A segment needs at least 20 hospitals to show a figure.
SegmentHospitalsMedian20th–80th
Hospital type
Acute care1,527$475$237 – $809
Children’s25$549$259 – $880
Critical access280$479$273 – $713
Ownership
For-profit199$645$271 – $1,635
Government229$414$221 – $690
Non-profit1,404$473$241 – $771
System affiliation
Part of a system1,628$489$241 – $809
Independent212$424$254 – $671

Cash price vs list price

Median list price (chargemaster)$800
Median cash price$476
Cash as a share of list, median hospital60%

At the typical hospital, asking for the cash price cuts the list price by about 40%. The share is the median of each hospital’s own cash ÷ list ratio, over hospitals that filed both — not the ratio of the two medians above.

The same procedure, inpatient

1,347 hospitals filed a usable inpatient cash price for this code. The median is $522 and the average of the middle 60% is $520; most fall between $277 and $796.

Cash price percentiles, inpatient, across 1,347 hospitals. Each figure is a price a hospital filed. 10th: one in ten hospitals charges less; 25th: a quarter charge less; Median: half charge less; 75th: three quarters charge less; 90th: nine in ten charge less.
10th25thMedian75th90th
$186$320$522$738$1,062

The most expensive tenth of hospitals charges at least 5.7× what the cheapest tenth charges ($186 vs $1,062).

Of the 1,442 hospitals that filed this code inpatient, 1,347 gave a usable cash price; 53 carried a plausibility flag, 0 filed a number their own filing marks as not a price, 0 gave an estimate, and 42 a list price only.

How complete is this

1,840 of the 3,956 hospitals with a price file in our corpus (47%) filed a usable outpatient cash price for this code, and those are the hospitals every figure on this page is computed from.

What the 2,000 hospitals that filed this code at all gave us
Usable cash price — counted1,840
Cash price carrying a plausibility flag — shown on the compare tool, excluded here105
A number the filing itself marks as not a price (a placeholder, a ratio) — excluded0
An estimate rather than a filed cash price — excluded1
A list price only, no cash figure — excluded54
Hospitals that filed this code2,000

Sections not shown for this setting

  • Since our last snapshot: there is no earlier snapshot at least 90 days older than this one yet.

We last checked these hospitals’ price files for changes between July 20, 2026 and September 24, 2026; the figures were computed September 25, 2026 from filings loaded through September 24, 2026. The percentiles and averages use only the “counted” row.

Related procedures

Part of the Upper gastrointestinal X-ray family.

Hospitals file this code under descriptions such as Radiologic Exam Esophagus Double Contrast Study|PROFESSIONAL COMPONENT.

Method

Source
The machine-readable price files every U.S. hospital is required by CMS to publish, parsed per hospital. Nothing is surveyed, sampled or modelled.
What counts
One cash (self-pay) price per hospital for this code and setting. A hospital’s own filing can rule its number out — a placeholder, a “not applicable” note, a list price standing in for cash — and our plausibility checks can flag a price far below what every other hospital files. Both kinds are disclosed above and excluded from the statistics; on the compare tool a flagged price is still shown.
Statistics
Percentiles are discrete: each is a price some hospital filed. The average is the mean of the prices between the 20th and 80th percentiles. We never publish the plain mean, the minimum or the maximum. A state needs 10 hospitals and a segment 20 to show a figure; otherwise the row shows its count and no number. Medicare is the national unadjusted OPPS rate where one exists.
Names
Procedure names on these pages are our own plain-language titles, not the AMA’s copyrighted CPT descriptors. The code is the identity.

The full rules — sources, statistics, thresholds, limitations — are on the methodology page.

Download this page’s figures: JSON · CSV. Aggregates only — the per-hospital prices are on the compare tool.

Cite: HospitalRates.com, “Barium swallow X-ray of the esophagus, double contrast (CPT 74221) — cash price report,” computed September 25, 2026. https://hospitalrates.com/procedures/cpt-74221-barium-swallow-x-ray-of-the-esophagus-double-contrast