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Georgia rates for HCPCS A9576

Injection, gadoteridol, (ProHance multipack), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $75.86 / $741.31
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $2.04
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.91 / $100.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $1.55 / $7.76
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.29 / $1.29 / $1.41
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.32 / $1.32 / $1.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.82
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.70 / $10.00
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $1,258.93 / $2,137.96
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.38 / $1.41 / $1.58
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.51 / $2.82 / $3.89
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $2.51