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Alaska rates for HCPCS A9576

Injection, gadoteridol, (ProHance multipack), per ml

Facilitymedian $1 · 10th–90th $1–$40%50%90th$1Professionalmedian $1 · 10th–90th $1–$70%50%90th$1$1.0$2.0$5.0$10.0$20.0$50.0

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
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $6.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.38 / $1.38 / $1.38
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.38 / $1.38 / $1.38
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.38 / $1.38 / $6.76
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.14 / $2.14 / $8.51
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.63 / $2.63 / $3.80
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.38 / $1.51 / $60.26
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.41 / $2.14 / $3.98