Gastrografin oral contrast solution at AMH Cath Labs LLC

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

DIATRIZOATE MEG-DIATRIZOAT SOD 66-10 % ORAL SOLN [3655]

Arlington, TX

See all hospitals reporting HCPCS Q9963 →

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Pricing by billing methodology

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How this price compares nationally

AMH Cath Labs LLC’s median price of $21 is 561% above the median hospital's median price ($3), higher than 63% of the 1,827 hospitals reporting HCPCS Q9963. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q9963 at AMH Cath Labs LLC

Negotiated rates from the hospital’s own file: 8 payers, 25 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	Blue Cross Blue Shield hmo fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
2	Blue Cross Blue Shield exchange fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
3	Blue Cross Blue Shield ppo fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
4	Blue Cross Blue Shield traditional fee schedule · outpatient	$2	$2	—	—	—	$2 – $2
5	Blue Cross Blue Shield managed medicaid percent of total billed charges · outpatientfrom % of charges	$4	$9	$9	103%	—	$0 – $21
6	UnitedHealthcare managed medicaid percent of total billed charges · outpatientfrom % of charges	$4	$9	$9	103%	—	$0 – $21
7	WellCare managed medicaid percent of total billed charges · outpatientfrom % of charges	$5	$9	$9	103%	—	$0 – $22
8	Molina managed medicaid percent of total billed charges · outpatientfrom % of charges	$5	$9	$10	103%	—	$0 – $23
9	Aetna managed medicaid percent of total billed charges · outpatientfrom % of charges	$5	$10	$10	103%	—	$0 – $23
10	Aetna whole health percent of total billed charges · inpatientfrom % of charges	$17	$34	$35	103%	—	$2 – $82
11	Aetna whole health percent of total billed charges · outpatientfrom % of charges	$21	$41	$42	103%	—	$2 – $99
12	Aetna commercial percent of total billed charges · inpatientfrom % of charges	$23	$45	$46	103%	—	$2 – $109
13	UnitedHealthcare all payer percent of total billed charges · outpatientfrom % of charges	$26	$50	$52	103%	—	$3 – $123
14	UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges	$27	$53	$55	103%	—	$3 – $130
15	Cigna oap/hmo percent of total billed charges · outpatientfrom % of charges	$28	$54	$56	103%	—	$3 – $131
16	Aetna commercial percent of total billed charges · outpatientfrom % of charges	$28	$54	$56	103%	—	$3 – $132
17	Phcs ppo percent of total billed charges · outpatientfrom % of charges	$35	$68	$70	103%	—	$3 – $165
18	Cigna ppo percent of total billed charges · outpatientfrom % of charges	$35	$68	$70	103%	—	$3 – $166
19	Aetna asa percent of total billed charges · outpatientfrom % of charges	$35	$68	$71	103%	—	$4 – $166
20	Aetna coventry percent of total billed charges · outpatientfrom % of charges	$35	$68	$71	103%	—	$4 – $166
21	Phcs ppo percent of total billed charges · inpatientfrom % of charges	$37	$73	$75	103%	—	$4 – $177
22	MultiPlan commercial percent of total billed charges · inpatientfrom % of charges	$44	$85	$88	103%	—	$4 – $207
23	MultiPlan commercial percent of total billed charges · outpatientfrom % of charges	$44	$85	$88	103%	—	$4 – $207
24	Cigna indemnity percent of total billed charges · inpatientfrom % of charges	$47	$92	$95	103%	—	$5 – $223
25	Cigna indemnity percent of total billed charges · outpatientfrom % of charges	$47	$92	$95	103%	—	$5 – $223

Last updated: Apr 21, 2026

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