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Hawaii rates for HCPCS A9576

Injection, gadoteridol, (ProHance multipack), per ml

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $1.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $1.74
HMSA
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2.04 / $2.04 / $2.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.70 / $2.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.45 / $2.14