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Maine rates for HCPCS Q9964

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.33 / $0.33
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
$0.28 / $0.28 / $99,999.99
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 / $0.28
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.27 / $0.33 / $0.33
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.39 / $0.56