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Montana rates for HCPCS Q9961

High osmolar contrast material, 250-299 mg/ml iodine concentration, per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.80 / $64.80 / $64.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.27 / $0.45
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64,999.99 / $81,499.99 / $94,999.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.31 / $0.52 / $1.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.24 / $0.31
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.13 / $0.27 / $0.75
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.26 / $0.31 / $0.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.24 / $0.24 / $0.24