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Montana 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
$0.33 / $0.33 / $0.51
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.37
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.31 / $0.36 / $0.59
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $1,800,000.00 / $2,400,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.39 / $0.39