Gastrografin oral contrast solution at Central Georgia Rehabilitation 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 MEGLUMINE-DIATRIZOATE SODIUM 66 %-10 % ORAL SOLUTION

Macon, GA

See all hospitals reporting HCPCS Q9963 →

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Pricing by billing methodology

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How this price compares nationally

Central Georgia Rehabilitation LLC’s median price of $72 is 2168% above the median hospital's median price ($3), higher than 80% 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 Central Georgia Rehabilitation LLC

Negotiated rates from the hospital’s own file: 8 payers, 20 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	Cigna commercial fee schedule · both	$0	$0	—	—	—	$0 – $0
2	Anthem hmo/ppo fee schedule · outpatient	$0	$0	—	—	—	$0 – $0
3	Humana hmo/pos fee schedule · both	$1	$1	—	—	—	$1 – $1
4	Humana ppo fee schedule · both	$1	$1	—	—	—	$1 – $1
5	Ambetter managed medicaid percent of total billed charges · outpatientfrom % of charges	$33	$48	$29	60%	—	$18 – $96
6	Ambetter managed medicaid percent of total billed charges · inpatientfrom % of charges	$56	$82	$49	60%	—	$31 – $162
7	Humana hmo/pos percent of total billed charges · outpatientfrom % of charges	$65	$94	$57	60%	—	$36 – $188
8	Aetna hmo percent of total billed charges · outpatientfrom % of charges	$65	$95	$57	60%	—	$36 – $188
9	Aetna pos percent of total billed charges · outpatientfrom % of charges	$72	$104	$63	60%	—	$40 – $207
10	Kaiser commercial percent of total billed charges · inpatientfrom % of charges	$72	$104	$63	60%	—	$40 – $207
11	Kaiser commercial percent of total billed charges · outpatientfrom % of charges	$72	$104	$63	60%	—	$40 – $207
12	MultiPlan pho agreement primary network percent of total billed charges · inpatientfrom % of charges	$72	$104	$63	60%	—	$40 – $207
13	MultiPlan pho agreement primary network percent of total billed charges · outpatientfrom % of charges	$72	$104	$63	60%	—	$40 – $207
14	Cigna commercial percent of total billed charges · outpatientfrom % of charges	$73	$106	$64	60%	—	$41 – $210
15	Humana ppo percent of total billed charges · outpatientfrom % of charges	$76	$110	$67	60%	—	$42 – $219
16	Aetna ppo percent of total billed charges · outpatientfrom % of charges	$76	$111	$67	60%	—	$43 – $220
17	MultiPlan pho agreement complimentary network percent of total billed charges · inpatientfrom % of charges	$88	$128	$78	60%	—	$49 – $255
18	MultiPlan pho agreement complimentary network percent of total billed charges · outpatientfrom % of charges	$88	$128	$78	60%	—	$49 – $255
19	Beechstreet commercial percent of total billed charges · inpatientfrom % of charges	$103	$149	$90	60%	—	$57 – $296
20	Beechstreet commercial percent of total billed charges · outpatientfrom % of charges	$103	$149	$90	60%	—	$57 – $296

Last updated: Nov 19, 2025

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