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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
$1.42 / $43.34 / $749.59
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.42 / $2.12
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.42 / $1.54 / $1.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.31 / $1.39 / $1.42
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.42 / $1.42 / $2.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.33 / $1.33 / $1.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.80
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.46 / $1.80 / $12.00
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$204.96 / $837.69 / $970.63
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.50 / $2.62
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.42 / $2.17