Gastrografin oral contrast solution at Carle BroMenn Medical Center

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

GASTROGRAFIN 66 %-10 % ORAL SOLUTION

Normal, IL

See all hospitals reporting HCPCS Q9963 →

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Pricing by billing methodology

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How this price compares nationally

Carle BroMenn Medical Center’s median price of $92 is 2804% above the median hospital's median price ($3), higher than 85% of the 1,837 hospitals reporting HCPCS Q9963. The highlighted bar is where this hospital falls; shaded is the middle 50% of hospitals.

Payers reporting HCPCS Q9963 at Carle BroMenn Medical Center

Negotiated rates from the hospital’s own file: 8 payers, 15 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	Humana medicare-medicaid (d-snp) fee schedule · inpatient	$0	$0	—	—	—	$0 – $0
2	Humana medicare-medicaid (d-snp) fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
3	Aetna Better Health medicare-medicaid (d-snp) fee schedule · inpatient	$0	$0	—	—	—	$0 – $0
4	Aetna Better Health medicare-medicaid (d-snp) fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
5	Molina managed medicaid percent of total billed charges · inpatientfrom % of charges	$35	$55	$32	59%	—	$30 – $100
6	Molina managed medicaid percent of total billed charges · outpatientfrom % of charges	$35	$55	$32	59%	—	$30 – $100
7	Molina medicare-medicaid (d-snp) percent of total billed charges · inpatientfrom % of charges	$35	$55	$32	59%	—	$30 – $100
8	Molina medicare-medicaid (d-snp) percent of total billed charges · outpatientfrom % of charges	$35	$55	$32	59%	—	$30 – $100
9	Blue Cross Blue Shield blue choice/options/ppo percent of total billed charges · outpatientfrom % of charges	$107	$169	$99	59%	3–30	$91 – $309
10	UnitedHealthcare ppo percent of total billed charges · outpatientfrom % of charges	$107	$170	$99	59%	—	$92 – $310
11	Blue Cross Blue Shield hmo percent of total billed charges · outpatientfrom % of charges	$108	$170	$100	59%	—	$92 – $311
12	Cigna ppo percent of total billed charges · outpatientfrom % of charges	$108	$170	$100	59%	—	$92 – $311
13	Aetna ppo percent of total billed charges · inpatientfrom % of charges	$115	$182	$106	59%	—	$98 – $332
14	Aetna ppo percent of total billed charges · outpatientfrom % of charges	$115	$182	$106	59%	—	$98 – $332
15	MultiPlan ppo percent of total billed charges · outpatientfrom % of charges	$131	$206	$121	59%	—	$111 – $376

Last updated: Apr 15, 2026

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