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Michigan rates for HCPCS A9576

Injection, gadoteridol, (ProHance multipack), per ml

Facilitymedian $89 · 10th–90th $4–$1150%20%40%10th90th$89Professionalmedian $1 · 10th–90th $1–$20%50%90th$1$1.0$5.0$20.0$100.0$500.0$2.0K

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
$9.77 / $89.13 / $114.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.00 / $1.41
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.41 / $1.41 / $1.41
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.45 / $2.24 / $3.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.45 / $1.45 / $1.51
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.38 / $1.48 / $1.48
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2.14 / $83.18 / $288.40
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.00 / $1.51 / $2.00
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.41 / $1.48 / $1.48
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1.38 / $1.45 / $3.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1.41 / $1.41 / $1.55