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Washington 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
$28.18 / $87.10 / $380.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.51 / $25.70 / $74.13
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.21 / $0.21 / $0.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.22 / $0.22 / $0.27
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.22 / $0.42 / $0.78
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.22 / $0.41 / $0.76
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $75.86
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.21 / $0.28 / $0.45
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.55 / $0.55 / $0.55
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.55 / $0.55 / $0.55
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.22 / $0.22 / $0.22
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.22 / $0.22 / $0.22
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.22 / $0.22 / $0.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.22 / $0.22 / $0.22
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.22 / $0.22 / $0.28