go back

Arkansas rates for HCPCS A9576

Injection, gadoteridol, (ProHance multipack), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $218.78 / $245.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.95
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.66
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.51 / $1.51 / $1.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.32 / $1.41 / $1.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.41
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.62 / $1.62 / $1.91
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $3.31