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Kentucky rates for HCPCS A9576

Injection, gadoteridol, (ProHance multipack), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.42 / $61.36 / $360.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.42 / $1.43
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.60 / $1.66 / $1.68
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.31 / $1.42 / $1.42
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.42 / $1.78 / $2.27
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.56 / $2.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.41 / $1.41 / $85.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.42 / $3.11
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.43 / $1.43 / $1.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.42 / $1.52