Gastrografin oral contrast solution at Mercy Perry

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.

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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

Perryville, MO

See all hospitals reporting HCPCS Q9963 →

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How this price compares nationally

Mercy Perry’s median price of $133 is 4047% above the median hospital's median price ($3), higher than 91% 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 Mercy Perry

Negotiated rates from the hospital’s own file: 16 payers, 29 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	Medicaid hb wash jefn linc samc pcmh stod il medicaid facility · percent of total billed charges · outpatientfrom % of charges	$32	$32	—	—	—	$32 – $32
2	Optum hb pcmh uhc all payer exchange facility · fee schedule · outpatient	$35	$35	—	—	—	$35 – $35
3	UnitedHealthcare hb pcmh uhc all payer exchange facility · fee schedule · outpatient	$35	$35	—	—	—	$35 – $35
4	UnitedHealthcare hb pcmh uhc core facility · fee schedule · outpatient	$35	$35	—	—	—	$35 – $35
5	Blue Cross Blue Shield hb pcmh missouri care health plan/healthy blue facility · percent of total billed charges · outpatientfrom % of charges	$43	$43	—	—	—	$43 – $43
6	Medicaid hb pcmh mo medicaid facility · percent of total billed charges · outpatientfrom % of charges	$43	$43	—	—	—	$43 – $43
7	UnitedHealthcare hb pcmh uhc managed medicaid facility · percent of total billed charges · outpatientfrom % of charges	$43	$43	—	—	—	$43 – $43
8	Blue Cross Blue Shield hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges	$65	$65	—	—	—	$65 – $65
9	Humana hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges	$65	$65	—	—	—	$65 – $65
10	Medica hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges	$65	$65	—	—	—	$65 – $65
11	Medicare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges	$65	$65	—	—	—	$65 – $65
12	UnitedHealthcare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges	$65	$65	—	—	—	$65 – $65
13	WellCare hb pcmh medicare/managed mcr w/seq 98.1% facility · percent of total billed charges · outpatientfrom % of charges	$65	$65	—	—	—	$65 – $65
14	UnitedHealthcare hb pcmh uhc medicare w/o seq facility · percent of total billed charges · outpatientfrom % of charges	$66	$66	—	—	—	$66 – $66
15	Aetna hb pcmh aetna/coventry medicare 102% w/o seq facility · percent of total billed charges · outpatientfrom % of charges	$68	$68	—	—	—	$68 – $68
16	Devoted hb pcmh devoted health medicare advantage 104% w/seq facility · percent of total billed charges · outpatientfrom % of charges	$68	$68	—	—	—	$68 – $68
17	Tricare hb pcmh tricare facility · percent of total billed charges · outpatientfrom % of charges	$78	$78	—	—	—	$78 – $78
18	Medica hb linc pcmh medica exchange new 010122 facility · percent of total billed charges · outpatientfrom % of charges	$90	$90	—	—	—	$90 – $90
19	Ambetter hb pcmh ambetter exchange facility · percent of total billed charges · outpatientfrom % of charges	$101	$101	—	—	—	$101 – $101
20	Blue Cross Blue Shield hb stlo wash jefn linc samc cape stod pcmh bcbs ascension facility · percent of total billed charges · outpatientfrom % of charges	$102	$102	—	—	—	$102 – $102
21	Blue Cross Blue Shield hb pcmh anthem blue preferred facility · percent of total billed charges · outpatientfrom % of charges	$133	$133	—	—	—	$133 – $133
22	Blue Cross Blue Shield hb pcmh anthem pathway/exchange facility · percent of total billed charges · outpatientfrom % of charges	$133	$133	—	—	—	$133 – $133
23	Aetna hb pcmh linc aetna coventry all products facility · percent of total billed charges · outpatientfrom % of charges	$140	$140	—	—	—	$140 – $140
24	First Health hb pcmh linc aetna coventry all products facility · percent of total billed charges · outpatientfrom % of charges	$140	$140	—	—	—	$140 – $140
25	Anthem hb pcmh anthem blue access facility · percent of total billed charges · outpatientfrom % of charges	$150	$150	—	—	—	$150 – $150

Page 1 of 2 · 29 rates

Last updated: Mar 12, 2026

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