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Montana rates for HCPCS A9575

Injection, gadoterate meglumine, 0.1 ml

Facilitymedian $0 · 10th–90th $0–$1,9950%20%10th90th$0Professionalmedian $14 · 10th–90th $0–$1550%10%20%10th90th$14$0.1$1.0$10.0$100.0$1.0K$10.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $218.78 / $1,995.26
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.20 / $22.91 / $245.47
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.42 / $46,773.51 / $91,201.08
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.16 / $0.16 / $0.16
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.56
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.09 / $0.09 / $0.13
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.14 / $0.14 / $0.38
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.14 / $0.14 / $0.38
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$0.13 / $0.13 / $0.56
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.09 / $79.43 / $85.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$0.10 / $0.10 / $0.10