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Florida rates for HCPCS A9576

Injection, gadoteridol, (ProHance multipack), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $57.54 / $467.74
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.41
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.07 / $1.41 / $100.00
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
Florida Blue
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.41
Florida Blue
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.51 / $1.78
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.63 / $2.63 / $2.82
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.74 / $2.34 / $3.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.48
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.41