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Kansas rates for HCPCS A9576

Injection, gadoteridol, (ProHance multipack), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.00 / $30.90 / $758.58
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.00 / $1.00 / $3.89
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.07 / $1.07 / $1.07
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5.89 / $7.59 / $10.00
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
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.45 / $2.14 / $3.89
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $7.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.23 / $1.41 / $1.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $2.29