go back

Idaho rates for HCPCS A9576

Injection, gadoteridol, (ProHance multipack), per ml

Facilitymedian $2 · 10th–90th $1–$60%20%10th90th$2Professionalmedian $1 · 10th–90th $1–$20%50%90th$1$1.0$2.0$5.0$10.0$20.0$50.0$100.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.41 / $1.41 / $104.71
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.58
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.45 / $3.72 / $5.25
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.51 / $3.31 / $3.31
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.51 / $1.58 / $3.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.38 / $1.38 / $1.38
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.38 / $1.48 / $2.51
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.48 / $2.82
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.07 / $1.07 / $1.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.38 / $1.38 / $1.66
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.38 / $1.38 / $1.48
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.41 / $1.41 / $2.29