go back

Maryland rates for HCPCS A9576

Injection, gadoteridol, (ProHance multipack), per ml

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1.42 / $1.42 / $43.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.42 / $1.63
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.41 / $1.41 / $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
$1.21 / $1.42 / $1.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.42 / $1.42 / $1.95
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.46 / $1.46 / $1.63