Low-osmolar contrast dye, 100-199 iodine, per mL

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

IOHEXOL 140 MG IODINE/ML INTRAVENOUS SOLUTION

Payers reporting HCPCS Q9965

Payer pricing summary

Low

Average

$95

Median

$54

High

$791

Payer rate distribution

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#
1	Ambetter fee schedule · both · +9 other terms	14	$176	$134	$73	55%	62	$1 – $219
2	UnitedHealthcare fee schedule · outpatient · +27 other terms	423	$2	$6	$34	528%	27	$1 – $536
3	Medcost percent of total billed charges · outpatientfrom % of charges · +6 other terms	23	$43	$76	$95	124%	4–40	$9 – $480
4	Cigna fee schedule · outpatient · +19 other terms	321	$2	$27	$138	509%	—	$0 – $2.1k
5	Blue Cross Blue Shield fee schedule · outpatient · +25 other terms	209	$2	$9	$142	1501%	—	$0 – $3.9k
6	Aetna fee schedule · outpatient · +23 other terms	164	$3	$63	$196	309%	—	$0 – $973
7	Humana fee schedule · outpatient · +18 other terms	158	$1	$5	$17	333%	—	$1 – $221
8	Anthem fee schedule · outpatient · +18 other terms	84	$1	$3	$15	453%	—	$0 – $223
9	Molina fee schedule · outpatient · +16 other terms	42	$3	$18	$74	406%	—	$0 – $626
10	Kaiser fee schedule · both · +14 other terms	41	$2	$2	$1	26%	—	$2 – $3
11	Caresource fee schedule · outpatient · +12 other terms	37	$2	$2	$2	122%	—	$1 – $16
12	Highmark facility · fee schedule · outpatient · +10 other terms	35	$1	$4	$3	74%	—	$1 – $12
13	MultiPlan fee schedule · inpatient · +16 other terms	29	$190	$176	$136	77%	—	$2 – $424
14	Baylor Scott White Health Plan facility · percent of total billed charges · inpatientfrom % of charges · +1 other terms	26	$174	$154	$25	16%	—	$121 – $188
15	Superior Healthplan facility · percent of total billed charges · outpatientfrom % of charges · +1 other terms	25	$36	$36	$16	45%	—	$13 – $83
16	Bcbs Tx fee schedule · outpatient · +4 other terms	24	$3	$3	$1	33%	—	$1 – $5
17	Medicaid fee schedule · outpatient · +8 other terms	21	$4	$11	$37	334%	—	$0 – $232
18	Regence professional · fee schedule · outpatient · +10 other terms	21	$1	$1	$0	3%	—	$1 – $2
19	First Health fee schedule · outpatient · +14 other terms	20	$4	$74	$107	145%	—	$2 – $347
20	Beechstreet percent of total billed charges · outpatientfrom % of charges · +3 other terms	19	$64	$65	$26	40%	—	$27 – $116
21	Optum professional · fee schedule · outpatient · +15 other terms	19	$2	$2	$1	34%	—	$1 – $4
22	Healthpartners fee schedule · outpatient · +11 other terms	18	$1	$1	$0	3%	—	$1 – $1
23	Medica professional · fee schedule · outpatient · +13 other terms	16	$2	$2	$0	11%	—	$1 – $2
24	WellCare professional · fee schedule · outpatient · +11 other terms	15	$1	$1	$0	30%	—	$1 – $2
25	Aetna Better Health fee schedule · outpatient · +9 other terms	14	$1	$2	$2	121%	—	$1 – $10

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