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Low Osmolar Contrast Material, Iodine 100-199 mg/mL

Pennsylvania rates for HCPCS Q9965

Low osmolar contrast material, 100-199 mg/ml iodine concentration, per ml

Rates data updated July 2026.

Facilitymedian $4 · 10th–90th $1$440%5%10%10th90th$4Professionalmedian $1 · 10th–90th $1$20%50%90th$1$0.2$2.0$20.0$200.0$2.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$0.93
Median
$3.72
Typical High
$43.65
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1.15
Median
$1.15
Typical High
$2.40
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$1.05
Median
$1.05
Typical High
$95.50
AmeriHealth
Setting
Professional
Modifier
Global
Typical Low
$1.23
Median
$1.23
Typical High
$1.23
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$2.19
Median
$2.51
Typical High
$8,511.38
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$2.51
Median
$2.51
Typical High
$2.51
Cigna
Setting
Facility
Modifier
Global
Typical Low
$1.15
Median
$4.07
Typical High
$4.27
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1.15
Median
$1.15
Typical High
$1.15
Emblem Health
Setting
Professional
Modifier
Global
Typical Low
$1.26
Median
$1.26
Typical High
$1.26
Geisinger
Setting
Facility
Modifier
Global
Typical Low
$1.15
Median
$1.15
Typical High
$1.15
Geisinger
Setting
Professional
Modifier
Global
Typical Low
$1.29
Median
$1.82
Typical High
$3.09
Highmark BCBS
Setting
Facility
Modifier
Global
Typical Low
$0.76
Median
$5.62
Typical High
$27.54
Independence Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$1.23
Median
$1.23
Typical High
$1.23
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$1.15
Median
$4.79
Typical High
$57.54
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$1.15
Median
$1.15
Typical High
$1.66
Oscar Health
Setting
Professional
Modifier
Global
Typical Low
$1.12
Median
$1.82
Typical High
$2.45
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$1.32
Median
$1.48
Typical High
$3.31
UPMC Health Plan
Setting
Professional
Modifier
Global
Typical Low
$1.48
Median
$1.48
Typical High
$1.74
United
Setting
Professional
Modifier
Global
Typical Low
$1.00
Median
$1.12
Typical High
$1.95