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Wisconsin rates for HCPCS Q9967

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

Facilitymedian $100 · 10th–90th $16–$4680%20%10th90th$100Professionalmedian $32 · 10th–90th $0–$1910%5%10th90th$32$0.0$0.2$2.0$20.0$200.0$2.0K

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
$38.02 / $100.00 / $489.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.91 / $39.81 / $213.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.15 / $0.15 / $0.23
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.15 / $0.21 / $0.28
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.15 / $0.17 / $0.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.20 / $0.31 / $0.52
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.15 / $0.19 / $0.38
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.15 / $0.16 / $0.59
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.16 / $0.26 / $0.31
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.33 / $1.41 / $6.31
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.15 / $0.15 / $1,513.56
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.15 / $50.12 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.13
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.11 / $0.15 / $0.28
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.16 / $0.37 / $1.10
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.15 / $85.11 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.15 / $0.32 / $1,513.56
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.14 / $0.20 / $0.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.14 / $0.14 / $0.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.15 / $79.43 / $100.00