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Connecticut rates for HCPCS A9576

Injection, gadoteridol, (ProHance multipack), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $3.98 / $4.07
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $2.29
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.82 / $2.24 / $4.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $3.98
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.41
ConnectiCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.45 / $1.51 / $1.74
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.35 / $1.41 / $1.58