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Maine rates for HCPCS Q9964

High osmolar contrast material, 400 or greater mg/ml iodine concentration, per ml

Insurance Carrier
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.03 / $0.03 / $0.03
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.28 / $100,000.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.28
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.28
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.35
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.05 / $1.05 / $1.05
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.39 / $0.52