go back

Utah rates for HCPCS Q9965

Low Osmolar Contrast Material 100-199 Mg/Ml Iodine Concentration Per Ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.11 / $24.72 / $187.69
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.96 / $1.06 / $23.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.33 / $1.60 / $2.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.96 / $0.96 / $0.96
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.20 / $1.31 / $60.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.96 / $1.14 / $1.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.96 / $0.96 / $0.96