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New Hampshire rates for HCPCS Q9967

Low osmolar contrast material, 300-399 mg/ml iodine concentration, per ml

Facilitymedian $93 · 10th–90th $17–$6030%10%20%10th90th$93Professionalmedian $19 · 10th–90th $0–$810%20%10th90th$19$0.1$1.0$10.0$100.0$1.0K

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
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$22.91 / $95.50 / $602.56
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $56.23 / $85.11
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.88 / $15.14 / $36.31
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.21 / $0.31 / $0.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.15 / $0.15 / $0.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.17 / $0.30 / $0.41
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.15 / $0.15 / $0.15
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.15 / $0.15 / $0.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.11 / $0.15 / $0.30
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.89 / $0.89 / $0.95