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Utah rates for HCPCS Q9965

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

Facilitymedian $25 · 10th–90th $1–$1860%10%20%10th90th$25Professionalmedian $1 · 10th–90th $1–$60%50%90th$1$1.0$5.0$20.0$100.0

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $24.55 / $186.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $6.17
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.23 / $1.38 / $2.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.15 / $1.15 / $1.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.20 / $1.32 / $60.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.15 / $1.15 / $1.55
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.98 / $1.05 / $1.26
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.05 / $1.15 / $1.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.05 / $1.10