go back

Maine rates for HCPCS Q9960

High osmolar contrast material, 200-249 mg/ml iodine concentration, per ml

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.15 / $0.15
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.20 / $0.23 / $0.31
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.28
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.27 / $0.27
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.12 / $0.15 / $0.15
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.18 / $0.18 / $0.27