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Montana rates for HCPCS Q9963

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.18 / $14.28 / $580.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.22 / $0.27 / $37.47
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
$0.25 / $0.25 / $0.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.22 / $0.22 / $0.25
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.17 / $0.25 / $0.59
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.23 / $0.26 / $0.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.22 / $0.22 / $0.22