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High Osmolar Contrast Material, Iodine 350-399 mg/mL

Hawaii rates for HCPCS Q9963 · Gastrografin, MD Gastroview

High osmolar contrast material, 350-399 mg/ml iodine concentration, per ml

Rates data updated October 2026.

How much does High Osmolar Contrast Material, Iodine 350-399 mg/mL cost?

$2.57per dose

One 10 mL dose, at the doctor's office rate. In Hawaii, October 2026.

Negotiated ratewhat insurers pay per mL of the drug
$0.26 / mL
Average doseacross Medicare claims, discarded units included
× 10 mL
One dosedrug only; giving it and the visit are billed separately
$2.57

Work out the cost of a dose

This drug is priced per mL. Enter the amount given to see what insurers have agreed to pay for it. Prefilled with the average administration in Medicare claims, discarded units included.

mL
In a doctor's office or clinic
$2.57

Drug cost only. Giving the drug, the visit itself and any monitoring are billed on their own codes. We do not publish dosing guidance: use the amount from your own prescription or treatment plan.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

How much rates vary

Professionalmedian $0 · 10th to 90th $0 to $0
$0.2professional $0

Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Professional
Modifier
None
Typical Low
$0.21
Median
$0.21
Typical High
$0.21
Cigna
Setting
Professional
Modifier
None
Typical Low
$0.21
Median
$0.26
Typical High
$0.26
HMSA
Setting
Professional
Modifier
None
Typical Low
$0.32
Median
$0.32
Typical High
$0.34
Kaiser Permanente
Setting
Professional
Modifier
None
Typical Low
$0.24
Median
$0.26
Typical High
$0.33
United
Setting
Professional
Modifier
None
Typical Low
$0.26
Median
$0.26
Typical High
$0.26
University Health Alliance
Setting
Professional
Modifier
None
Typical Low
$0.25
Median
$0.26
Typical High
$0.34

Where Hawaii sits

The same service costs 2.7 times more in Wyoming than in New Hampshire. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Hawaii· 3rd of 51

$0.26

WY $0.56NH $0.21

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.