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New Mexico 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
$0.27 / $0.34 / $0.34
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.22 / $0.27 / $18.73
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$56,799.99 / $68,899.99 / $81,099.99
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.22 / $0.22 / $0.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.22 / $0.22 / $0.22
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.22 / $0.30 / $60.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.11 / $0.23 / $0.42
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.22 / $0.22 / $0.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.22 / $0.22 / $0.22