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Arizona rates for HCPCS Q9950

Injection Sulfur Hexafluoride Lipid Microspheres Per Ml(Reinstated 01/01/2016) Low Osmolar Contrast Material 350-399 Mg/Ml Iodine Concentration Per Ml (Del 12/31/07)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$22.49 / $37.29 / $95.20
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$19.34 / $22.49 / $63.61
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$16.30 / $64.84 / $101.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$12.37 / $17.98 / $118.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$18.59 / $18.59 / $18.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.59 / $18.59 / $18.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.57 / $22.50 / $75.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.59 / $18.59 / $18.59
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$18.59 / $18.59 / $18.59