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

Louisiana 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?

$2.19per dose

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

Negotiated ratewhat insurers pay per mL of the drug: $0.22 / mL
Average doseacross Medicare claims, discarded units included: × 10 mL
One dosedrug only; giving it and the visit are billed separately: $2.19

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.

Amount givenmL

In a doctor's office or clinic: $2.19
At a hospital outpatient department: $2.40

The same drug, in the same amount, costs 10% more at a hospital than at a doctor's office.

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 We do not publish dosing guidance: use the amount from your own prescription or treatment plan.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 4 insurance carriers under federal price transparency rules.

Where the price changes

Given at	Per mL	Per 10 mL dose
Doctor's office or clinic	$0.22	$2.19
Hospital outpatient department	$0.24	$2.40

How much rates vary

Facilitymedian $0 · 10th to 90th $0 to $1Professionalmedian $0 · 10th to 90th $0 to $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	Facility/Professional	Modifier	Typical Low	Median	Typical High
Aetna Setting Facility Modifier None Typical Low $0.21 Median $0.23 Typical High $0.34	Facility	None	$0.21	$0.23	$0.34
Aetna Setting Professional Modifier None Typical Low $0.21 Median $0.22 Typical High $0.22	Professional	None	$0.21	$0.22	$0.22
BCBS Louisiana Setting Facility Modifier None Typical Low $0.24 Median $0.24 Typical High $0.46	Facility	None	$0.24	$0.24	$0.46
BCBS Louisiana Setting Professional Modifier None Typical Low $0.24 Median $0.24 Typical High $0.24	Professional	None	$0.24	$0.24	$0.24
Cigna Setting Facility Modifier None Typical Low $0.21 Median $0.40 Typical High $0.56	Facility	None	$0.21	$0.40	$0.56
Cigna Setting Professional Modifier None Typical Low $0.21 Median $0.21 Typical High $0.21	Professional	None	$0.21	$0.21	$0.21
United Setting Professional Modifier None Typical Low $0.22 Median $0.22 Typical High $0.56	Professional	None	$0.22	$0.22	$0.56

Where Louisiana 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.

Louisiana· 28th of 51

$0.22

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.