go back

Pennsylvania rates for HCPCS Q9964

High Osmolar Contrast Material 400 Or Greater Mg/Ml Iodine Concentration Per Ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.53
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.32 / $0.33 / $0.33
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.55 / $0.65 / $8,459.92
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.65 / $0.65 / $0.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.28 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.28
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $38,249.62
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.85
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.33 / $0.33 / $0.45
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.22 / $0.33 / $0.51
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.28 / $0.28 / $85.00
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.28 / $0.28 / $0.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.39 / $0.39 / $0.49